Healthcare Provider Details

I. General information

NPI: 1497817852
Provider Name (Legal Business Name): VIRGINIA PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 03/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7702 E PARHAM RD SUITE 304
RICHMOND VA
23294-4371
US

IV. Provider business mailing address

PO BOX 28598
RICHMOND VA
23228-8598
US

V. Phone/Fax

Practice location:
  • Phone: 804-346-1507
  • Fax: 804-915-0035
Mailing address:
  • Phone: 804-346-1507
  • Fax: 804-915-0035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0101235462
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number10107328
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number StateVA

VIII. Authorized Official

Name: MRS. DEBBIE SIDERIO
Title or Position: PRACTICE MANAGER
Credential:
Phone: 804-346-1507