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General NPI Number Information
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NPI Number | 1962134445
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Entity Type | Organization
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Legal Business Name | UVA COMMUNITY HEALTH MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 06/24/2022
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 629 CEDAR CREEK GRADE STE B
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City | WINCHESTER
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State | VA
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Zip | 22601-2786
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Country | US
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Telephone | 540-678-3950
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Fax | 540-678-3954
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Provider Business Mailing Address
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Address Line | PO BOX 936952
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City | ATLANTA
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State | GA
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Zip | 31193-6952
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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 | CFO
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Name | CHARLES D CODER
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Credential |
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Telephone | 804-835-2069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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