MEDICARE: MOUNTAIN VIEW MEDICAL ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1720161797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNTAIN VIEW MEDICAL ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	PO BOX 704
Second Line	:
City	:	ROUND HILL
State	:	VA
Zip	:	20142
Country	:	US
Telephone Number	:	540-751-0255
Fax Number	:	540-751-0466

Provider Business Practice Location Address
First Line	:	6 EAST LOUDOUN STREET
Second Line	:
City	:	ROUND HILL
State	:	VA
Zip	:	20141
Country	:	US
Telephone Number	:	540-751-0255
Fax Number	:	540-751-0466

Authorized Official
Title or Position	:	OWNER
Name	:	ANNETTE M HUDLER
Credential	:	DO
Telephone Number	:	540-751-0255

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	08/22/2020

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