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General NPI Number Information
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NPI Number | 1386187540
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE REGIONAL MEDICAL CENTER, P.C.
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Dates
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Enumeration Date | 11/21/2016
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 8266 ATLEE RD STE 224
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-1813
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Country | US
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Telephone | 804-454-7240
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Fax | 540-658-2846
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Provider Business Mailing Address
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Address Line | 8266 ATLEE RD STE 224
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-1813
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Country | US
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Telephone | 804-454-7240
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Fax | 540-658-2846
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN ERLE
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Credential | D.C.
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Telephone | 540-373-1303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024173092
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License Number State | VA
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