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MID-ATLANTIC ELDERCARE PLLC NPI 1902094774


NPI Information

NPI: 1902094774
Provider Name: MID-ATLANTIC ELDERCARE, PLLC
Classification: Family Medicine - 207QG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

Address:
5261 CARROLLTON PIKE
SUITE B
WOODLAWN, VA
ZIP 24381
Phone: (276) 238-8876
Get Directions

MID-ATLANTIC ELDERCARE, PLLC is a geriatric medicine family medicine in Woodlawn, VA. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. MID-ATLANTIC ELDERCARE, PLLC NPI is 1902094774. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5261 CARROLLTON PIKE
SUITE B
WOODLAWN, VA
ZIP 24381-030
Phone: (276) 238-8876
Fax: (276) 238-8886

The provider's authorized official is Bradley J Goad .
The authorized official title is Owner and has the following contact phone number (276) 238-8876.

The enumeration date for this NPI number is 10/5/2007 and was last updated on 9/24/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QG0300XFamily MedicineGeriatric MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1001763MEDICARE PINVIRGINIA
2DN2980OTHERGROUP PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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