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General NPI Number Information
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NPI Number | 1861680662
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Entity Type | Organization
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Legal Business Name | RIVERSBEND HOSPITALISTS P.C.
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Dates
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Enumeration Date | 10/06/2007
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 3611 BOULEVARD
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-1344
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Country | US
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Telephone | 804-526-2816
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Fax | 804-526-2817
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Provider Business Mailing Address
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Address Line | 3611 BOULEVARD
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-1344
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Country | US
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Telephone | 804-526-2816
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Fax | 804-526-2817
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAPHAEL IWEBUNOR AGADA
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Credential | M.D.
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Telephone | 804-943-8127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101840582
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License Number State | VA
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