MEDICARE: FOUNDATION MEDICAL CENTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	208D00000X	General Practice Physician
3	207Q00000X	Family Medicine Physician
4	261Q00000X	Clinic/Center
5	251S00000X	Community/Behavioral Health Agency
6	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1821655432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUNDATION MEDICAL CENTER

Provider Business Mailing Address
First Line	:	300A TEMPLE LAKE DR
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-2972
Country	:	US
Telephone Number	:	804-301-5242
Fax Number	:

Provider Business Practice Location Address
First Line	:	300A TEMPLE LAKE DR
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-2972
Country	:	US
Telephone Number	:	804-301-5242
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. WILLIAM EUGENE MASSENBURG JR.
Credential	:
Telephone Number	:	804-301-5242

Provider Enumeration Date	:	05/20/2019
Last Update Date	:	01/14/2026

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Directions to “FOUNDATION MEDICAL CENTER ” Practice Location

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