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REVERENT MEDICAL GROUP INC NPI 1457861403


NPI Information

NPI: 1457861403
Provider Name: REVERENT MEDICAL GROUP INC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 49D2182234

Address:
623 EMANCIPATION HWY STE 101
FREDERICKSBURG, VA
ZIP 22401
Phone: (800) 452-5574
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REVERENT MEDICAL GROUP INC is an internal medicine in Fredericksburg, VA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. REVERENT MEDICAL GROUP INC NPI is 1457861403. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

623 EMANCIPATION HWY STE 101
FREDERICKSBURG, VA
ZIP 22401-437
Phone: (800) 452-5574
Fax: (540) 940-6249

The provider's authorized official is Petros Ayele .
The authorized official title is Co Owner and has the following contact phone number (202) 821-3040.

The CLIA number assigned to this NPI record is 49D2182234 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/4/2017 and was last updated on 10/12/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineYes

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: 4/28/2024

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