| Direct Access Internal Medicine Ltd | |
|
6609 Main St Gloucester VA 23061-5194 | |
| (804) 832-0391 | |
| Not Available |
| Full Name | Direct Access Internal Medicine Ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 6609 Main St, Gloucester, Virginia |
| Authorized Official Name and Position | Ronald Haggerty (OWNER) |
| Authorized Official Contact | 8048320391 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Direct Access Internal Medicine Ltd 6609 Main St Gloucester VA 23061-5194 Ph: () - | Direct Access Internal Medicine Ltd 6609 Main St Gloucester VA 23061-5194 Ph: (804) 832-0391 |
| NPI Number | 1639476831 |
|---|---|
| Provider Enumeration Date | 02/24/2011 |
| Last Update Date | 02/24/2011 |
| Medicare PECOS PAC ID | 1456538545 |
|---|---|
| Medicare Enrollment ID | O20110526000369 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639476831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ronald D Haggerty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083702385 PECOS PAC ID: 7416930490 Enrollment ID: I20040610000966 |
| Provider Name | Lauri B Lebel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447211792 PECOS PAC ID: 4082680988 Enrollment ID: I20040902000385 |
| Provider Name | Katherine C Haggerty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700947769 PECOS PAC ID: 7911954425 Enrollment ID: I20050406001174 |
| Provider Name | Brad E Skelding |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861597692 PECOS PAC ID: 1850496464 Enrollment ID: I20070410000314 |
| Provider Name | Blair Williams Nein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679165823 PECOS PAC ID: 9537578109 Enrollment ID: I20210511002907 |
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