MEDICARE: FINCH FAMILY MEDICAL CARE. PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	0101223610	VA

General Provider Information

NPI Number	:	1043463466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FINCH FAMILY MEDICAL CARE. PLLC

Provider Business Mailing Address
First Line	:	1318 EUCLID AVE
Second Line	:	SUITE 2-3
City	:	BRISTOL
State	:	VA
Zip	:	24201-3830
Country	:	US
Telephone Number	:	276-466-0744
Fax Number	:	276-466-1628

Provider Business Practice Location Address
First Line	:	1318 EUCLID AVE
Second Line	:	SUITE 2-3
City	:	BRISTOL
State	:	VA
Zip	:	24201-3830
Country	:	US
Telephone Number	:	276-466-0744
Fax Number	:	276-466-1628

Authorized Official
Title or Position	:	OWNER
Name	:	SHANNON M. FINCH
Credential	:	M.D.
Telephone Number	:	276-466-0744

Provider Enumeration Date	:	10/29/2008
Last Update Date	:	12/12/2012

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