| First Choice Medical Center Llc | |
|
4876 Baxter Road Virginia Beach VA 23462 | |
| (757) 671-7777 | |
| Not Available |
| Full Name | First Choice Medical Center Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4876 Baxter Road, Virginia Beach, Virginia |
| Authorized Official Name and Position | Nasser Hambaz (OWNER) |
| Authorized Official Contact | 7576717777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| First Choice Medical Center Llc 4876 Baxter Road Virginia Beach VA 23462 Ph: (757) 671-7777 | First Choice Medical Center Llc 4876 Baxter Road Virginia Beach VA 23462 Ph: (757) 671-7777 |
| NPI Number | 1972759496 |
|---|---|
| Provider Enumeration Date | 08/15/2008 |
| Last Update Date | 04/26/2015 |
| Medicare PECOS PAC ID | 7315001989 |
|---|---|
| Medicare Enrollment ID | O20090126000631 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972759496 | NPI | - | NPPES |
| 5680255 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101037952 (Virginia) | Primary |
| Provider Name | Nasser Hambaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174533129 PECOS PAC ID: 8325102999 Enrollment ID: I20090126000623 |
| Provider Name | Shirin Maryah Dalai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346583846 PECOS PAC ID: 2567689763 Enrollment ID: I20140812001854 |
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