Basic Information
| Provider Information | |||||||||
| NPI: | 1700173481 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GEORGES | ||||||||
| FirstName: | GEORGE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8266 ATLEE RD | ||||||||
| Address2: | SUITE 332 | ||||||||
| City: | MECHANICSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 231161804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8047647686 | ||||||||
| FaxNumber: | 8047647689 | ||||||||
| Practice Location | |||||||||
| Address1: | 3420 PUMP RD # 113 | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8042232404 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2011 | ||||||||
| LastUpdateDate: | 08/17/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | 0101259884 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | C06115 | 01 | VA | GROUP PTAN | OTHER |