Healthcare Provider Details

I. General information

NPI: 1548170319
Provider Name (Legal Business Name): BRIDGECARE MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 HUNT CLUB BLVD
HAMPTON VA
23666-2274
US

IV. Provider business mailing address

4410 CLAIBORNE SQ E STE 334
HAMPTON VA
23666-2074
US

V. Phone/Fax

Practice location:
  • Phone: 757-209-2889
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: AHMED DARDEIR
Title or Position: OWNER
Credential:
Phone: 757-209-2889