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Specialty details in registry · Fredericksburg, VA

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At a glance

1936 William St, Fredericksburg, VA 22401-5128

NPPES record updated Jan 30, 2025. Public records can lag behind changes at a practice.

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Practice location

1936 William St
Fredericksburg, VA 22401-5128

Professional details: NPI, taxonomy & registry record

NPI1861205080

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 156F00000X
Enumeration date: Jan 30, 2025
Record updated: Jan 30, 2025

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

156F00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1936 William St
Fredericksburg, VA 22401-5128

Phone: (646) 288-3876

Mailing address

1936 WILLIAM ST

FREDERICKSBURG, VA 224015128

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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