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General NPI Number Information
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NPI Number | 1801334297
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Entity Type | Organization
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Legal Business Name | RIVERSIDE PHYSICIAN SERVICES INC
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 02/06/2017
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Provider Practice Location Address
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Address Line | 20486 MARKET STREET
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City | ONANCOCK
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State | VA
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Zip | 23417
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Country | US
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Telephone | 757-302-2700
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Fax | 757-787-9262
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Provider Business Mailing Address
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Address Line | 856 J CLYDE MORRIS BLVD SUITE A
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-1318
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Country | US
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Telephone | 757-316-5960
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Fax | 757-534-5190
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Authorized Official
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Title or Position | CFO
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Name | BRADEN MILLER
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Credential |
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Telephone | 757-316-5800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State | VA
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Taxonomy #6
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | VA
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Taxonomy #7
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | VA
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Taxonomy #8
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State | VA
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Taxonomy #9
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | VA
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