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General NPI Number Information
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NPI Number | 1710282827
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Entity Type | Organization
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Legal Business Name | RIVER'S WAY HEALTHCARE OF VIRGINIA PLLC
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Dates
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Enumeration Date | 01/20/2011
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Last Update Date | 01/20/2011
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Provider Practice Location Address
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Address Line | 1791 CAMBRIDGE DR SUITE 203
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City | RICHMOND
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State | VA
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Zip | 23238-5839
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Country | US
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Telephone | 804-658-0435
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Fax | 804-562-8584
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Provider Business Mailing Address
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Address Line | 1791 CAMBRIDGE DR SUITE 203
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City | RICHMOND
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State | VA
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Zip | 23238-5839
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Country | US
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Telephone | 804-658-0435
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Fax | 804-562-8584
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Authorized Official
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Title or Position | PRESIDENT
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Name | NANCY A POWELL
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Credential | M.D.
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Telephone | 804-658-0435
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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 | 0101044021
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License Number State | VA
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