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NPI Code Detail

MEDICARE: GRACE FAMILY MEDICINE PLC

MEDICARE: GRACE FAMILY MEDICINE PLC
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
1261QP2300XPrimary Care Clinic/Center0101054652VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11013905785OTHERVANPI

General Provider Information

NPI Number : 1285944983
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRACE FAMILY MEDICINE PLC
Provider Business Mailing Address
First Line : 15421 FOREST RD STE B
Second Line :
City : FOREST
State : VA
Zip : 24551-2274
Country : US
Telephone Number : 434-525-4722
Fax Number :
Provider Business Practice Location Address
First Line : 15421 FOREST RD STE B
Second Line :
City : FOREST
State : VA
Zip : 24551-2274
Country : US
Telephone Number : 434-525-4722
Fax Number :
Authorized Official
Title or Position : PHYSICIAN OWNER
Name : DR. SCOTT B ADAMS
Credential : MD
Telephone Number : 434-525-4722
Provider Enumeration Date : 10/15/2010
Last Update Date : 10/15/2010

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Directions to “GRACE FAMILY MEDICINE PLC ” Practice Location

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