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General NPI Number Information
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NPI Number | 1366634917
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Entity Type | Organization
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Legal Business Name | ALBEMARLE INTERNAL MEDICINE
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Dates
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Enumeration Date | 08/16/2007
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Last Update Date | 08/16/2007
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Provider Practice Location Address
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Address Line | 199 SPOTNAP RD SUITE 1
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-8827
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Country | US
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Telephone | 434-962-6345
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6129
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22906-6129
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Country | US
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Telephone | 434-962-6345
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | RICHARD ALAN STEWART
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Credential | M.D.
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Telephone | 434-962-6345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0101044428
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License Number State | VA
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