| Organization Name: | MGMC, LLC |
| NPI Number: | 1336547900 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHANIE SCHNEIDER (VP) |
| Mailing Address: | 9455 Lorton Market St Ste 200 Lorton |
| State: | VA US |
| Postal Code: | 220791962 |
| Phone Number: | 7039713701 |
| Fax Number: | 7033396351 |
| NPI Enumeration Date: | 12/15/2014 |
| NPI Last Update Date: | 12/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |