Provider Demographics
NPI:1982752648
Name:VIRGINIA INTEGRATIVE MEDICINE PLC
Entity type:Organization
Organization Name:VIRGINIA INTEGRATIVE MEDICINE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-984-2846
Mailing Address - Street 1:901 PRESTON AVE
Mailing Address - Street 2:SUITE 402-3
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4491
Mailing Address - Country:US
Mailing Address - Phone:434-984-2846
Mailing Address - Fax:434-984-3846
Practice Address - Street 1:901 PRESTON AVE
Practice Address - Street 2:SUITE 402-3
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4491
Practice Address - Country:US
Practice Address - Phone:434-984-2846
Practice Address - Fax:434-984-3846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2013-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101029437261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care