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General NPI Number Information
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NPI Number | 1093240608
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Entity Type | Organization
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Legal Business Name | SF MEDICAL CONSULTING, LLC
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Dates
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Enumeration Date | 04/21/2017
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Last Update Date | 04/21/2017
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Provider Practice Location Address
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Address Line | 2212 WEBSTER CRESCENT LN
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-1747
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Country | US
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Telephone | 804-998-3390
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Fax | 804-417-4323
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Provider Business Mailing Address
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Address Line | 2212 WEBSTER CRESCENT LN
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-1747
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Country | US
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Telephone | 804-998-3390
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Fax | 804-417-4323
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | MICHAEL P FOGEL
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Credential | PA-C
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Telephone | 804-998-3390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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