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1770 N Parham Rd Ste 100 Richmond VA 23229-4658 | |
(804) 665-5457 | |
Not Available |
Full Name | |
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Speciality | Pediatrics |
Location | 1770 N Parham Rd Ste 100, Richmond, Virginia |
Authorized Official Name and Position | Usama Samaan (PRESIDENT) |
Authorized Official Contact | 8046655457 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1770 N Parham Rd Ste 100 Richmond VA 23229-4658 Ph: (804) 665-5457 | 1770 N Parham Rd Ste 100 Richmond VA 23229-4658 Ph: (804) 665-5457 |
NPI Number | 1588339766 |
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Provider Enumeration Date | 08/10/2021 |
Last Update Date | 08/03/2022 |
Medicare PECOS PAC ID | 8921494204 |
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Medicare Enrollment ID | O20220414000038 |
Identifier | Type | State | Issuer |
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1588339766 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
208000000X | Pediatrics | (* (Not Available)) | Primary |
Provider Name | Usama Samaan |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1124316211 PECOS PAC ID: 7416250519 Enrollment ID: I20160125000354 |
Mary Brantley Holmes Msn Whnp-bc Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8955 Wishart Rd, Richmond, VA 23229 Phone: 804-928-5596 | |
Independent Associates Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7605 Forest Ave, Ste 211, Richmond, VA 23229 Phone: 804-282-3114 Fax: 804-285-9723 | |