MEDIDOCTORS PRIMARY CARE LLC NPI 1063467975

NPI Information

  • NPI: 1063467975
  • Provider Name: MEDIDOCTORS PRIMARY CARE LLC
  • Classification: Internal Medicine - 207RI0200X
  • Specialization: Infectious Disease
  • Entity Type: Organization
  • Address: 1001 SAM PERRY BLVD
    FREDERICKSBURG, VA
    ZIP 22401
  • Phone: (540) 741-1428

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NPI Details

MEDIDOCTORS PRIMARY CARE LLC is an infectious disease internal medicine in Fredericksburg, VA. The provider is an internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. MEDIDOCTORS PRIMARY CARE LLC NPI is 1063467975. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1001 SAM PERRY BLVD
FREDERICKSBURG, VA
ZIP 22401-453
Phone: (540) 741-1428
Fax: (540) 741-1420

The provider's authorized official is Robert K Lively .
The authorized official title is Executive Director and has the following contact phone number (540) 741-1473.

The enumeration date for this NPI number is 5/23/2006 and was last updated on 10/17/2007.

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
1207Q00000XFamily MedicineNo
2207RC0200XInternal MedicineCritical Care MedicineNo
3207RS0012XInternal MedicineSleep MedicineNo
4207VM0101XObstetrics & GynecologyMaternal & Fetal MedicineNo
5207RI0200XInternal MedicineInfectious DiseaseYes

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
1C09276MEDICARE PINVIRGINIA

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: 11/21/2025

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