Unknown Individual – Family Medicine Physician, NPI 1306241575
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
PO BOX 5275
GLEN ALLEN, VA 230585275
Phone: (804) 708-9480
Fax: (804) 708-0865
Type: Mailing
46 BROAD STREET RD
SUITE A
MANAKIN SABOT, VA 231032213
Phone: (804) 708-9480
Fax: (804) 708-0865
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 23058)
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