Provider Demographics
NPI:1528124575
Name:PSYCHIATRIC ALLIANCE OF THE BLUE RIDGE
Entity type:Organization
Organization Name:PSYCHIATRIC ALLIANCE OF THE BLUE RIDGE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P D
Authorized Official - Last Name:SHEMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-984-6777
Mailing Address - Street 1:2496 OLD IVY ROAD
Mailing Address - Street 2:SUITE 400 1ST FLOOR
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4895
Mailing Address - Country:US
Mailing Address - Phone:434-984-6777
Mailing Address - Fax:434-296-1412
Practice Address - Street 1:2496 OLD IVY ROAD
Practice Address - Street 2:SUITE 400 1ST FLOOR
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4895
Practice Address - Country:US
Practice Address - Phone:434-984-6777
Practice Address - Fax:434-296-1412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty