Shenandoah Emergency Medicine Specialists LLC

Organization Active NPI Emergency Medicine Physician · Fishersville, VA

NPI 1083706121 · NPPES record last updated Jun 18, 2015

Key facts

NPI
1083706121
Entity type
Organization (NPI type 2)
Primary specialty
Emergency Medicine Physician 207P00000X
Legal business name
SHENANDOAH EMERGENCY MEDICINE SPECIALISTS LLC
Practice address
78 Medical Drive
Fishersville, VA 22939-1000
Phone
(540) 332-4423
Fax
(540) 332-5658
NPI assigned
Sep 28, 2006
Organization subpart
No

Authorized official

Name
Glen E Michael, MD NPI 1407052210
Title
Cfo
Phone
(540) 332-4423

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 61

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 61

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070306000507 VA Part B Supplier - Clinic/Group Practice 0345343620 Receives reassigned benefits from 57 practitioners
Practice locations: Fishersville, VA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207P00000X Yes

Addresses

Primary practice location

78 Medical Drive
Fishersville, VA 22939-1000

Mailing address

PO Box 11107
Daytona Beach, FL 32120-1107
Phone (888) 311-8760

Other providers in Fishersville, VA

All providers in Fishersville, VA · Emergency Medicine Physician in Virginia

Sources for this page

Verify at the official NPI Registry.