| Glenside Medical Associates, Llc | |
|
4000a Glenside Dr Richmond VA 23228-4102 | |
| (804) 262-4763 | |
| (804) 264-9683 |
| Full Name | Glenside Medical Associates, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4000a Glenside Dr, Richmond, Virginia |
| Authorized Official Name and Position | Robin Campbell (SR DIRECTOR, ENTERPRISE REVENUE CYC) |
| Authorized Official Contact | 8042624763 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenside Medical Associates, Llc 4000a Glenside Dr Richmond VA 23228-4102 Ph: (804) 262-4763 | Glenside Medical Associates, Llc 4000a Glenside Dr Richmond VA 23228-4102 Ph: (804) 262-4763 |
| NPI Number | 1215936901 |
|---|---|
| Provider Enumeration Date | 07/15/2005 |
| Last Update Date | 09/22/2023 |
| Medicare PECOS PAC ID | 9032253596 |
|---|---|
| Medicare Enrollment ID | O20100222000428 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215936901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Adam K Gelrud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982676276 PECOS PAC ID: 0840270435 Enrollment ID: I20040723000444 |
| Provider Name | Glenn B Mizrach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437158128 PECOS PAC ID: 4385788850 Enrollment ID: I20100316000942 |
| Provider Name | Kevin L Powers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609875293 PECOS PAC ID: 5294879763 Enrollment ID: I20100316000958 |
| Provider Name | Stephen M Ashe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952300634 PECOS PAC ID: 3476697947 Enrollment ID: I20100316000975 |
| Provider Name | John P White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336148923 PECOS PAC ID: 7416082458 Enrollment ID: I20100316000990 |
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