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General NPI Number Information
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NPI Number | 1093475766
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Entity Type | Organization
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Legal Business Name | SIX OAKS MEDICINE LLC
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 239 FAIRVIEW LN
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City | BERRYVILLE
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State | VA
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Zip | 22611-2489
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Country | US
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Telephone | 540-877-4237
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Fax | 540-217-3400
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Provider Business Mailing Address
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Address Line | 239 FAIRVIEW LN
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City | BERRYVILLE
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State | VA
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Zip | 22611-2489
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Country | US
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Telephone | 540-877-4237
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Fax | 540-217-3400
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Authorized Official
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Title or Position | MD
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Name | CHRISTINE AIELLO
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Credential | MD
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Telephone | 540-877-4454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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