Provider Demographics
NPI:1720161797
Name:MOUNTAIN VIEW MEDICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:MOUNTAIN VIEW MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:540-751-0255
Mailing Address - Street 1:PO BOX 704
Mailing Address - Street 2:
Mailing Address - City:ROUND HILL
Mailing Address - State:VA
Mailing Address - Zip Code:20142
Mailing Address - Country:US
Mailing Address - Phone:540-751-0255
Mailing Address - Fax:540-751-0466
Practice Address - Street 1:6 EAST LOUDOUN STREET
Practice Address - Street 2:
Practice Address - City:ROUND HILL
Practice Address - State:VA
Practice Address - Zip Code:20141
Practice Address - Country:US
Practice Address - Phone:540-751-0255
Practice Address - Fax:540-751-0466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty