Healthcare Provider Details

I. General information

NPI: 1245709088
Provider Name (Legal Business Name): ACCESS HEALTHCARE MULTI-SPECIALTY GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2018
Last Update Date: 11/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2103 GRAVES MILL RD
FOREST VA
24551-2675
US

IV. Provider business mailing address

2103 GRAVES MILL RD
FOREST VA
24551-2675
US

V. Phone/Fax

Practice location:
  • Phone: 434-316-7199
  • Fax: 434-316-6185
Mailing address:
  • Phone: 434-316-7199
  • Fax: 434-316-6185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW WILLIAM PIELECK
Title or Position: OWNER
Credential: DO
Phone: 434-316-7199