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General NPI Number Information
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NPI Number | 1235354754
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Entity Type | Organization
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Legal Business Name | HMG PSYCHIATRIC ASSOCIATES PC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 07/13/2022
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Provider Practice Location Address
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Address Line | 5918 HARBOR PARK DRIVE
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-0027
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Country | US
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Telephone | 804-639-0400
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Fax | 804-639-0445
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Provider Business Mailing Address
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Address Line | PO BOX 5567
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-0027
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Country | US
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Telephone | 804-353-0010
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Fax | 804-353-0041
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Authorized Official
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Title or Position | PRESIDENT HMG PSYCHIATRIC ASSOCIATE
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Name | MARIO GOMEZ
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Credential | MD
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Telephone | 804-639-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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