| Sentara Gynecology Specialists | |
|
2206 Wilborn Ave Medical Office Building #1 South Boston VA 24592 | |
| (434) 517-8627 | |
| Not Available |
| Full Name | Sentara Gynecology Specialists |
|---|---|
| Speciality | Clinic/Center |
| Location | 2206 Wilborn Ave, South Boston, Virginia |
| Authorized Official Name and Position | Robert A Broermann (CFO) |
| Authorized Official Contact | 7574557020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sentara Gynecology Specialists 2204 Wilborn Ave South Boston VA 24592-1645 Ph: (757) 455-7395 | Sentara Gynecology Specialists 2206 Wilborn Ave Medical Office Building #1 South Boston VA 24592 Ph: (434) 517-8627 |
| NPI Number | 1033728803 |
|---|---|
| Provider Enumeration Date | 07/28/2020 |
| Last Update Date | 10/04/2023 |
| Medicare PECOS PAC ID | 4587572805 |
|---|---|
| Medicare Enrollment ID | O20201112003144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033728803 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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