Provider Demographics
NPI:1104097542
Name:METROHEALTH INTERNAL MEDICINE, PC
Entity type:Organization
Organization Name:METROHEALTH INTERNAL MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-371-4488
Mailing Address - Street 1:450 GARRISONVILLE RD STE 215
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-1615
Mailing Address - Country:US
Mailing Address - Phone:540-318-8167
Mailing Address - Fax:540-318-8165
Practice Address - Street 1:450 GARRISONVILLE RD STE 215
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-1615
Practice Address - Country:US
Practice Address - Phone:540-318-8167
Practice Address - Fax:540-318-8165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty