Provider Demographics
NPI:1003055484
Name:GARCIA, NICOLA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLA
Middle Name:ANN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 HOSPITAL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-1928
Mailing Address - Country:US
Mailing Address - Phone:276-670-7141
Mailing Address - Fax:
Practice Address - Street 1:319 HOSPITAL DR STE 101
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-1928
Practice Address - Country:US
Practice Address - Phone:276-670-7141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP67743207LC0200X, 207RP1001X
VA204277914207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1003055484Medicaid
VA1003055484Medicaid