| Colonial Medcare Pc | |
|
2801 Boulevard Suite B Colonial Heights VA 23834-2323 | |
| (804) 524-0524 | |
| (804) 524-0520 |
| Full Name | Colonial Medcare Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2801 Boulevard, Colonial Heights, Virginia |
| Authorized Official Name and Position | Irshad Ahmed (PRESIDENT) |
| Authorized Official Contact | 8045240524 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colonial Medcare Pc 2801 Boulevard Suite B Colonial Heights VA 23834-2323 Ph: (804) 524-0524 | Colonial Medcare Pc 2801 Boulevard Suite B Colonial Heights VA 23834-2323 Ph: (804) 524-0524 |
| NPI Number | 1255390092 |
|---|---|
| Provider Enumeration Date | 03/21/2006 |
| Last Update Date | 02/19/2014 |
| Medicare PECOS PAC ID | 3476650854 |
|---|---|
| Medicare Enrollment ID | O20070518000370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255390092 | NPI | - | NPPES |
| 1255390092 | Other | VA | GROUP NPI NUMBER |
| 005867151 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Irshad Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083683528 PECOS PAC ID: 9335033232 Enrollment ID: I20040211000877 |
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