| Greater Suffolk Medical Center | |
|
114 N Main St Ste 200 Suffolk VA 23434-4564 | |
| (757) 934-1003 | |
| (757) 934-1660 |
| Full Name | Greater Suffolk Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 114 N Main St Ste 200, Suffolk, Virginia |
| Authorized Official Name and Position | Michael T Williams (PRESIDENT) |
| Authorized Official Contact | 7579341003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Suffolk Medical Center 114 N Main St Ste 200 Suffolk VA 23434-4564 Ph: (757) 934-1003 | Greater Suffolk Medical Center 114 N Main St Ste 200 Suffolk VA 23434-4564 Ph: (757) 934-1003 |
| NPI Number | 1619016284 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 04/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619016284 | NPI | - | NPPES |
| 12068 | Other | VA | OPTIMA |
| 77906536 | Medicaid | NC | |
| 110007205 | Medicaid | VA | |
| 45055 | Other | VA | OPTIMA |
| 890658E | Medicaid | NC | |
| 13762 | Other | VA | OPTIMA |
| 095436 | Other | VA | BLUE CROSS |
| 5813735 | Medicaid | VI | |
| 7360720 | Medicaid | NC | |
| 6068286 | Medicaid | VI | |
| 041021 | Other | VA | BLUE CROSS |
| 12104 | Other | VA | OPTIMA |
| 7906203 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101033710 (Virginia) | Primary |
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