| Atwood Family Medical Center | |
|
108 Knells Ridge Blvd Suite 108 Chesapeake VA 23320-4885 | |
| (757) 436-1234 | |
| (757) 548-3665 |
| Full Name | Atwood Family Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 108 Knells Ridge Blvd, Chesapeake, Virginia |
| Authorized Official Name and Position | Ronald Atwood (PRESIDENT) |
| Authorized Official Contact | 7574361234 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atwood Family Medical Center 108 Knells Ridge Blvd Suite 108 Chesapeake VA 23320-4885 Ph: (757) 436-1234 | Atwood Family Medical Center 108 Knells Ridge Blvd Suite 108 Chesapeake VA 23320-4885 Ph: (757) 436-1234 |
| NPI Number | 1982637575 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 09/24/2008 |
| Medicare PECOS PAC ID | 8123077617 |
|---|---|
| Medicare Enrollment ID | O20050122000012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982637575 | NPI | - | NPPES |
| 091662 | Other | VA | BCBS GROUP |
| CH1314 | Other | RR MCARE GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Eleanor Lynn Deguzman-berube |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669440061 PECOS PAC ID: 2264563287 Enrollment ID: I20100708000082 |
| Provider Name | Ronald Wayne Atwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932177375 PECOS PAC ID: 7113976606 Enrollment ID: I20100708000093 |
| Provider Name | Megan Nicole Cannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871885616 PECOS PAC ID: 8325226400 Enrollment ID: I20110620000100 |
| Provider Name | Jarrod Lynn Elsass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700328978 PECOS PAC ID: 1052693934 Enrollment ID: I20180502003017 |
| Provider Name | Stephanie Danielle Hendrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790241594 PECOS PAC ID: 1951642669 Enrollment ID: I20190408000150 |
| Provider Name | Meagan Taylor Yauilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942880414 PECOS PAC ID: 0446651996 Enrollment ID: I20210622002485 |
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