Provider Demographics
NPI:1730242371
Name:FIRST MED INC
Entity type:Organization
Organization Name:FIRST MED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:TALBOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-984-4200
Mailing Address - Street 1:125 RIVERBEND DR STE 3
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8695
Mailing Address - Country:US
Mailing Address - Phone:434-984-4200
Mailing Address - Fax:434-984-6242
Practice Address - Street 1:125 RIVERBEND DR STE 3
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8695
Practice Address - Country:US
Practice Address - Phone:434-984-4200
Practice Address - Fax:434-984-6242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046855207Q00000X
VA0101034548207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005617081Medicaid
VA1720055767Medicare UPIN
VA080007465Medicare ID - Type Unspecified
VA930001495Medicare ID - Type Unspecified
VA1568439040Medicare UPIN
VA005827108Medicare ID - Type Unspecified