| Williamsburg Professional Services | |
|
5483 Mooretown Rd Williamsburg VA 23188-2108 | |
| (757) 941-6400 | |
| Not Available |
| Full Name | Williamsburg Professional Services |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5483 Mooretown Rd, Williamsburg, Virginia |
| Authorized Official Name and Position | Paul Gilbert (CHIEF LEGAL OFFICER) |
| Authorized Official Contact | 7579415095 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Williamsburg Professional Services Po Box 87 Lightfoot VA 23090-0087 Ph: (757) 941-5095 | Williamsburg Professional Services 5483 Mooretown Rd Williamsburg VA 23188-2108 Ph: (757) 941-6400 |
| NPI Number | 1740529866 |
|---|---|
| Provider Enumeration Date | 02/08/2013 |
| Last Update Date | 06/25/2024 |
| Certification Date | 06/25/2024 |
| Medicare PECOS PAC ID | 7214176684 |
|---|---|
| Medicare Enrollment ID | O20130614000287 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740529866 | NPI | - | NPPES |
| Provider Name | Meredith S Ragan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548250871 PECOS PAC ID: 2365330834 Enrollment ID: I20040306000164 |
| Provider Name | Durre Nayab Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841409067 PECOS PAC ID: 4981896271 Enrollment ID: I20101005000597 |
| Provider Name | Zahid Hameed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194956193 PECOS PAC ID: 5395916522 Enrollment ID: I20110920000766 |
| Provider Name | Avtar S Dhillon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134210784 PECOS PAC ID: 1254598832 Enrollment ID: I20120209000423 |
| Provider Name | Kenneth Richmond |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184891277 PECOS PAC ID: 6608015342 Enrollment ID: I20141016000420 |
| Provider Name | Jonathan C Lee |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1821284753 PECOS PAC ID: 3678897972 Enrollment ID: I20150114002333 |
| Provider Name | Geranameo Vladmire Bullock |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275821340 PECOS PAC ID: 8022258920 Enrollment ID: I20160301002216 |
| Provider Name | Norriece Liana Gibson |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1962763573 PECOS PAC ID: 6709024797 Enrollment ID: I20170706003002 |
| Provider Name | Jennifer Pittman-dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497254320 PECOS PAC ID: 5395090484 Enrollment ID: I20180613001569 |
| Provider Name | Sarah Faber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205313913 PECOS PAC ID: 9335491059 Enrollment ID: I20181008003507 |
| Provider Name | Kojo Sarfo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457913964 PECOS PAC ID: 0941630156 Enrollment ID: I20200430000261 |
| Provider Name | Birju Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699018317 PECOS PAC ID: 1557608338 Enrollment ID: I20200811000228 |
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