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General NPI Number Information
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NPI Number | 1174013171
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Entity Type | Organization
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Legal Business Name | SHENANDOAH NEPHROLOGY, PLC
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Dates
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Enumeration Date | 05/15/2018
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Last Update Date | 11/09/2018
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Provider Practice Location Address
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Address Line | 4057 QUARLES CT
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City | ROCKINGHAM
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State | VA
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Zip | 22801-8717
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Country | US
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Telephone | 540-208-7002
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Fax | 540-217-2339
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Provider Business Mailing Address
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Address Line | 4057 QUARLES CT
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City | ROCKINGHAM
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State | VA
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Zip | 22801-8717
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Country | US
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Telephone | 540-208-7002
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Fax | 540-217-2339
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Authorized Official
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Title or Position | DOCTOR
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Name | TERRY OVERBY
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Credential | MD
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Telephone | 540-208-7002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State | VA
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