| Airline Boulevard Medical Associates | |
|
3537 Airline Blvd Ste 1 Portsmouth VA 23701-2650 | |
| (757) 738-1225 | |
| (757) 488-1037 |
| Full Name | Airline Boulevard Medical Associates |
|---|---|
| Speciality | Family Medicine |
| Location | 3537 Airline Blvd Ste 1, Portsmouth, Virginia |
| Authorized Official Name and Position | Stephan Quiriconi (CFO) |
| Authorized Official Contact | 8042818301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Airline Boulevard Medical Associates 8580 Magellan Pkwy Richmond VA 23227-1149 Ph: (804) 627-5462 | Airline Boulevard Medical Associates 3537 Airline Blvd Ste 1 Portsmouth VA 23701-2650 Ph: (757) 738-1225 |
| NPI Number | 1326477506 |
|---|---|
| Provider Enumeration Date | 11/07/2013 |
| Last Update Date | 05/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326477506 | NPI | - | NPPES |
| C05149 | Other | VA | GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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