| Ende Medical Practice, Llp | |
|
121 S Market St Petersburg VA 23803-4217 | |
| (804) 733-8771 | |
| (804) 733-1017 |
| Full Name | Ende Medical Practice, Llp |
|---|---|
| Speciality | Internal Medicine |
| Location | 121 S Market St, Petersburg, Virginia |
| Authorized Official Name and Position | Stefanie Lea Eads (BILLING CLERK) |
| Authorized Official Contact | 8047338909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ende Medical Practice, Llp 121 S Market St Petersburg VA 23803-4217 Ph: (804) 733-8771 | Ende Medical Practice, Llp 121 S Market St Petersburg VA 23803-4217 Ph: (804) 733-8771 |
| NPI Number | 1710007430 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 04/26/2010 |
| Medicare PECOS PAC ID | 1759556459 |
|---|---|
| Medicare Enrollment ID | O20111207000866 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710007430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Frederick Ivan Ende |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497855373 PECOS PAC ID: 3577738277 Enrollment ID: I20111207000873 |
| Provider Name | Mark Ende |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528152824 PECOS PAC ID: 9739354432 Enrollment ID: I20111207000881 |
| Provider Name | Stefanie L Eads |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437636503 PECOS PAC ID: 2961750971 Enrollment ID: I20180808001245 |
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