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NPI Code Detail

MEDICARE: MARYVIEW HOSPITAL

MEDICARE: MARYVIEW HOSPITAL
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
1208VP0000XPain Medicine Physician

General Provider Information

NPI Number : 1871802413
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARYVIEW HOSPITAL
Provider Business Mailing Address
First Line : 8580 MAGELLAN PKWY
Second Line :
City : RICHMOND
State : VA
Zip : 23227-1149
Country : US
Telephone Number : 804-627-5462
Fax Number : 866-449-0896
Provider Business Practice Location Address
First Line : 3315 HIGH ST
Second Line :
City : PORTSMOUTH
State : VA
Zip : 23707-3319
Country : US
Telephone Number : 757-399-0759
Fax Number : 757-399-8247
Authorized Official
Title or Position : CFO
Name : STEPHAN QUIRICONI
Credential :
Telephone Number : 804-281-8301
Provider Enumeration Date : 09/30/2010
Last Update Date : 05/29/2019

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1093707606 — MR. ROBERT J MENDEZ DO
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1962682534 — MRS. KATIE JANE GERARGE PA-C
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1538460837 — BOBBI JO OLDAKER FNP
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Directions to “MARYVIEW HOSPITAL ” Practice Location

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