Provider Demographics
NPI:1720618184
Name:MCFARLANE, EGBERT CHARLES
Entity Type:Individual
Prefix:
First Name:EGBERT
Middle Name:CHARLES
Last Name:MCFARLANE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6712 GILLS GATE TER
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-6001
Mailing Address - Country:US
Mailing Address - Phone:804-252-9429
Mailing Address - Fax:
Practice Address - Street 1:1314 E NINE MILE RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23075-2306
Practice Address - Country:US
Practice Address - Phone:804-252-9429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care