Provider First Line Business Practice Location Address: 
VCUHS DEPT OF EMERGENCY MEDICINE RESIDENCY
    Provider Second Line Business Practice Location Address: 
1250 E MARSHALL ST
    Provider Business Practice Location Address City Name: 
RICHMOND
    Provider Business Practice Location Address State Name: 
VA
    Provider Business Practice Location Address Postal Code: 
23298-0401
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
804-828-0996
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
04/06/2023