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NPI 1861063935

NPI 1861063935 : REAL SIMPLE HEALTHCARE LLC : PETERSBURG, VA

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General NPI Number Information
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    NPI Number           |    1861063935
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    Entity Type          |    Organization 
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    Legal Business Name  |    REAL SIMPLE HEALTHCARE LLC 
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Dates
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    Enumeration Date     |    07/08/2021
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    Last Update Date     |    11/20/2021
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Provider Practice Location Address
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    Address Line         |    601 OLD WAGNER RD BLDG D 
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    City                 |    PETERSBURG
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    State                |    VA
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    Zip                  |    23805-9313
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    Country              |    US
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    Telephone            |    607-425-1810
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    601 OLD WAGNER RD BLDG D 
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    City                 |    PETERSBURG
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    State                |    VA
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    Zip                  |    23805-9313
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    AUTHORIZED OFFICIAL
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    Name                 |     ZAHID  RASHID 
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    Credential           |    MD
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    Telephone            |    800-518-0138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    213ES0103X
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    Taxonomy Name        |    Foot & Ankle Surgery Podiatrist
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    License Number       |    
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    License Number State |    
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