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General NPI Number Information
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NPI Number | 1598225955
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Entity Type | Organization
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Legal Business Name | WHOLEHEALTH MEDICAL
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 03/21/2019
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Provider Practice Location Address
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Address Line | 1800 TIMBERWOOD BLVD STE A
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-7544
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Country | US
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Telephone | 434-305-0501
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Fax | 844-429-0456
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Provider Business Mailing Address
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Address Line | 730 LOCHRIDGE LN
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City | EARLYSVILLE
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State | VA
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Zip | 22936-9640
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Country | US
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Telephone | 804-399-8185
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KAITLYN BEISECKER-LEVIN
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Credential | MD
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Telephone | 434-305-0501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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