MEDICARE: CHARLOTTE HOPE CAMPBELL

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207RG0100X	Gastroenterology Physician	0101278803	VA

General Provider Information

NPI Number	:	1144752312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLOTTE HOPE CAMPBELL

Provider Business Mailing Address
First Line	:	8266 ATLEE ROAD
Second Line	:	MEDICAL OFFICE BUILDING II, SUITE 133
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116
Country	:	US
Telephone Number	:	804-285-8206
Fax Number	:

Provider Business Practice Location Address
First Line	:	2369 STAPLES MILL RD STE 200
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-2918
Country	:	US
Telephone Number	:	833-833-7531
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2017
Last Update Date	:	06/05/2023

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