Mary Ellen Cullom, MD | |
11800 Rock Landing Dr, Newport News, VA 23606-4206 | |
(757) 643-8800 | |
(757) 643-8919 |
Full Name | Mary Ellen Cullom |
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Gender | Female |
Speciality | Ophthalmology |
Location | 11800 Rock Landing Dr, Newport News, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275503864 | NPI | - | NPPES |
1275503864 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207W00000X | Ophthalmology | 0101049366 (Virginia) | Primary |
Entity Name | Riverside Physician Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194929026 PECOS PAC ID: 5092608448 Enrollment ID: O20040207000400 |
Mailing Address | Practice Location Address |
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Mary Ellen Cullom, MD 856 J Clyde Morris Blvd, Suite A, Newport News, VA 23601-1318 Ph: () - | Mary Ellen Cullom, MD 11800 Rock Landing Dr, Newport News, VA 23606-4206 Ph: (757) 643-8800 |
Andrew W Lewis, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 11800 Rock Landing Dr, Newport News, VA 23606 Phone: 757-643-8800 Fax: 757-643-8919 | |
John Frederick Frantz Ii, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 12420 Warwick Blvd, Suite 1d, Newport News, VA 23606 Phone: 757-599-0700 Fax: 757-594-5207 | |
Dr. Laura Kueny, MD Ophthalmology Medicare: Medicare Enrolled Practice Location: 12420 Warwick Blvd Ste 1d, Newport News, VA 23606 Phone: 757-596-3806 | |
Hugh E Berckmueller, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 704 Thimble Shoals Blvd, #100, Newport News, VA 23606 Phone: 757-595-8404 Fax: 757-595-8353 | |
Robert Gregory Elgin, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 11800 Rock Landing Dr, Newport News, VA 23606 Phone: 757-643-8800 Fax: 757-643-8919 | |
Anthony John Derosa, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 860 Omni Blvd, Suite 201, Newport News, VA 23606 Phone: 757-223-5321 Fax: 757-223-7271 |