| K.s. Boodram, Md Pllc | |
|
4300 Crossings Blvd Ste 101 Prince George VA 23875-1452 | |
| (804) 526-7900 | |
| (804) 526-7195 |
| Full Name | K.s. Boodram, Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4300 Crossings Blvd Ste 101, Prince George, Virginia |
| Authorized Official Name and Position | Sharon Boodram (PRACTICE MANAGER) |
| Authorized Official Contact | 8045267900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| K.s. Boodram, Md Pllc 4300 Crossings Blvd Ste 101 Prince George VA 23875-1452 Ph: (804) 526-7900 | K.s. Boodram, Md Pllc 4300 Crossings Blvd Ste 101 Prince George VA 23875-1452 Ph: (804) 526-7900 |
| NPI Number | 1093926552 |
|---|---|
| Provider Enumeration Date | 05/25/2007 |
| Last Update Date | 03/10/2024 |
| Medicare PECOS PAC ID | 6406800796 |
|---|---|
| Medicare Enrollment ID | O20050309000763 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093926552 | NPI | - | NPPES |
| 0408689 | Other | VA | UNITED HEALTHCARE |
| 7604973 | Other | VA | GHI |
| 010124701 | Medicaid | VA | |
| 8130003 | Other | VI | MAMSI |
| 0504963 | Other | VI | CIGNA |
| 254668 | Other | VI | SOUOTHERN HEALTH |
| 3689195 | Other | VA | AETNA HMO |
| 54180 | Other | VI | CARENET |
| 172714 | Other | VA | ANTHEM |
| 7404178 | Other | VA | AETNA PPO |
| 94167 | Other | VA | SENTARA OPTIMA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101229800 (Virginia) | Primary |
| Provider Name | Kadarnath S Boodram |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679546923 PECOS PAC ID: 4880682905 Enrollment ID: I20040505001229 |
Careatc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6000 Quality Way, Prince George, VA 23875 Phone: 800-993-8244 | |
Prime Care Family Practice, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4700 Puddledock Road, Suite 300, Prince George, VA 23875 Phone: 804-526-1111 Fax: 804-526-8363 | |
Cvhs Hopewell Prince George Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4260 Crossings Blvd, Suite 2, Prince George, VA 23875 Phone: 434-542-5560 Fax: 434-542-5745 |