Southside Primary Care, Inc.
NPI #1184952707 in Fredericksburg, Virginia
Provider Information
- NPI Number
- 1184952707
- Entity Type
- Organization
- Organization Name
- Southside Primary Care, Inc.
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Nov 19, 2009
- Last Updated
- Nov 19, 2009
Practice Location
- Address
- 4103 LAFAYETTE BLVD
- Address 2
- SUITE 2
- City
- Fredericksburg
- State
- Virginia
- ZIP Code
- 22408-4274
- Phone
- (540) 891-5550
Authorized Official
- Name
- ASHLEIGH A RAUBENOLT
- Title
- CREDENTIALING
- Phone
- (540) 371-4488
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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