Provider Demographics
NPI:1235742529
Name:DOGWOOD MEDICAL
Entity Type:Organization
Organization Name:DOGWOOD MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRYE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:804-971-8314
Mailing Address - Street 1:PO BOX 11768
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-0168
Mailing Address - Country:US
Mailing Address - Phone:804-281-3319
Mailing Address - Fax:804-213-9783
Practice Address - Street 1:311 CEDAR GROVE RD
Practice Address - Street 2:
Practice Address - City:FARNHAM
Practice Address - State:VA
Practice Address - Zip Code:22460
Practice Address - Country:US
Practice Address - Phone:804-971-8314
Practice Address - Fax:804-213-9783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty