Provider Demographics
NPI:1093240608
Name:SF MEDICAL CONSULTING, LLC
Entity type:Organization
Organization Name:SF MEDICAL CONSULTING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:FOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:804-998-3390
Mailing Address - Street 1:2212 WEBSTER CRESCENT LN
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-1747
Mailing Address - Country:US
Mailing Address - Phone:804-998-3390
Mailing Address - Fax:804-417-4323
Practice Address - Street 1:2212 WEBSTER CRESCENT LN
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-1747
Practice Address - Country:US
Practice Address - Phone:804-998-3390
Practice Address - Fax:804-417-4323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty