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General NPI Number Information
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NPI Number | 1437016805
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Entity Type | Organization
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Legal Business Name | SCMD MEDICAL PC
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 100 SHOCKROE SLIP FL 2
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City | RICHMOND
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State | VA
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Zip | 23219
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Country | US
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Telephone | 607-289-3684
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Fax |
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Provider Business Mailing Address
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Address Line | 401 PARK AVE S FL 10
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City | NEW YORK
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State | NY
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Zip | 10016-8808
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | JOHN DOLORES
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Credential |
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Telephone | 916-385-4849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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