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General NPI Number Information
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NPI Number | 1821608035
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Entity Type | Organization
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Legal Business Name | PHYSICIANS EDGE
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Dates
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Enumeration Date | 08/03/2020
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 2300 FALL HILL AVE STE 511
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3362
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Country | US
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Telephone | 540-741-0547
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 FALL HILL AVE STE 511
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3362
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Country | US
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Telephone | 540-741-0547
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. SHARON THOMAS
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Credential |
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Telephone | 540-741-0547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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