Provider Demographics
NPI:1922293331
Name:PIEDMONT HEALTH & WELLNESS, P.C.
Entity Type:Organization
Organization Name:PIEDMONT HEALTH & WELLNESS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HUNGARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-799-5800
Mailing Address - Street 1:4545 RIVERSIDE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-5171
Mailing Address - Country:US
Mailing Address - Phone:434-799-5800
Mailing Address - Fax:434-799-5801
Practice Address - Street 1:4545 RIVERSIDE DR
Practice Address - Street 2:SUITE A
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-5171
Practice Address - Country:US
Practice Address - Phone:434-799-5800
Practice Address - Fax:434-799-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101224431261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG72139Medicare UPIN
VAC10367Medicare PIN