Audrey Louise Grant, MD | |
3636 High St, Portsmouth, VA 23707-3236 | |
(757) 398-2200 | |
Not Available |
Full Name | Audrey Louise Grant |
---|---|
Gender | Female |
Speciality | Emergency Medicine |
Location | 3636 High St, Portsmouth, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194765826 | NPI | - | NPPES |
139PJ | Other | NC | BLUE CROSS |
P00247878 | Other | VA | RAILROAD MEDICARE |
64315286 | Medicaid | KY | |
5900979 | Medicaid | NC | |
P00328958 | Other | NC | RAILROAD MEDICARE |
1194765826 | Medicaid | VA | |
170709 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 0101043829 (Virginia) | Primary |
Entity Name | Emergency Coverage Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427005008 PECOS PAC ID: 3072412592 Enrollment ID: O20050418000414 |
Entity Name | Inova Health Care Services |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952320061 PECOS PAC ID: 2466351093 Enrollment ID: O20080806000696 |
Mailing Address | Practice Location Address |
---|---|
Audrey Louise Grant, MD Po Box 634706, Cincinnati, OH 45263-0001 Ph: (865) 292-3000 | Audrey Louise Grant, MD 3636 High St, Portsmouth, VA 23707-3236 Ph: (757) 398-2200 |
Eric Sulava, Emergency Medicine Medicare: Medicare Enrolled Practice Location: 620 John Paul Jones Cir, Naval Medical Center Portsmouth, Portsmouth, VA 23708 Phone: 757-953-0669 | |
Dr. David Wayne Champ, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 620 John Paul Jones Cir, Portsmouth, VA 23708 Phone: 757-953-1407 | |
Dr. Brian Michael Keuski, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 620 John Paul Jones Cir, Portsmouth, VA 23708 Phone: 757-953-5000 | |
Dr. Joel Martin Schofer, MD, MBA, CPE Emergency Medicine Medicare: Medicare Enrolled Practice Location: 620 John Paul Jones Cir, Portsmouth, VA 23708 Phone: 302-824-4411 | |
Dr. David Ryan Lamborn, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 620 John Paul Jones Circle, Portsmouth, VA 23708 Phone: 757-953-5000 | |
Dr. Johnathan Paul Kinzer, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3636 High St, Portsmouth, VA 23707 Phone: 443-717-0272 | |
Keneth Kwame Sarpong, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3636 High St, Portsmouth, VA 23707 Phone: 757-398-2200 |