NPI 1982151577 · live from the CMS NPI Registry
Complete Care Medical Group LLC
Dermatology in Montross, VA. National Provider Identifier 1982151577, active.
NPI record
| NPI | 1982151577 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 41 Peach Grove Ln, Montross, VA 22520 |
| Practice phone | 804-410-3322 |
| Enumerated | September 1, 2016 |
| Last updated | February 15, 2017 |
| Authorized official | Ashley Williams, Operations Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist | 213E00000X | 010300694 (VA) |
| Dermatology primary | 207N00000X | 0101236987 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.