Provider Demographics
NPI:1164989331
Name:SCRUGGS, MIASIA K
Entity Type:Individual
Prefix:
First Name:MIASIA
Middle Name:K
Last Name:SCRUGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W FRANKLIN ST APT 708W
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4957
Mailing Address - Country:US
Mailing Address - Phone:804-869-6623
Mailing Address - Fax:
Practice Address - Street 1:300 W FRANKLIN ST APT 708W
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-4957
Practice Address - Country:US
Practice Address - Phone:804-869-6623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health