| Hampton Roads Medical Specialists Pc | |
|
2131 S Bonito Way Meridian ID 83642-1659 | |
| (208) 489-9500 | |
| Not Available |
| Full Name | Hampton Roads Medical Specialists Pc |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 2131 S Bonito Way, Meridian, Idaho |
| Authorized Official Name and Position | Stephen L Green (PRESIDENT) |
| Authorized Official Contact | 7578699922 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hampton Roads Medical Specialists Pc 26 Town Center Way # 704 Hampton VA 23666-1999 Ph: (757) 771-8049 | Hampton Roads Medical Specialists Pc 2131 S Bonito Way Meridian ID 83642-1659 Ph: (208) 489-9500 |
| NPI Number | 1013986579 |
|---|---|
| Provider Enumeration Date | 03/16/2006 |
| Last Update Date | 02/21/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013986579 | NPI | - | NPPES |
| 006069479 | Medicaid | VA | |
| 1477679496 | Other | VA | NPI INDIVIDUAL |
| 1013986579 | Other | VA | NPI CORPORATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 0101028335 (Virginia) | Primary |
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