Dominion Medical Center, LLC

NPI #1114109261 in King George, Virginia

Provider Information

NPI Number: 1114109261
Entity Type: Organization
Organization Name: Dominion Medical Center, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Nov 30, 2007
Last Updated: Mar 17, 2008

Practice Location

Address: 11463 RIDGE RD
City: King George
State: Virginia
ZIP Code: 22485-4078
Phone: (301) 870-3540

Authorized Official

Name: MARYANN AYERS
Title: ADMINISTRATOR
Phone: (301) 870-3540

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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