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NPI Code Detail

MEDICARE: RIVERSBEND HOSPITALISTS P.C.

MEDICARE: RIVERSBEND HOSPITALISTS P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician0101840582VA

General Provider Information

NPI Number : 1861680662
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVERSBEND HOSPITALISTS P.C.
Provider Business Mailing Address
First Line : 3611 BOULEVARD
Second Line :
City : COLONIAL HEIGHTS
State : VA
Zip : 23834-1344
Country : US
Telephone Number : 804-526-2816
Fax Number : 804-526-2817
Provider Business Practice Location Address
First Line : 3611 BOULEVARD
Second Line :
City : COLONIAL HEIGHTS
State : VA
Zip : 23834-1344
Country : US
Telephone Number : 804-526-2816
Fax Number : 804-526-2817
Authorized Official
Title or Position : PRESIDENT
Name : DR. RAPHAEL IWEBUNOR AGADA
Credential : M.D.
Telephone Number : 804-943-8127
Provider Enumeration Date : 10/06/2007
Last Update Date : 12/05/2023

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