| Mid-atlantic Family Practice | |
|
1020 Independence Blvd #103 Virginia Beach VA 23455-5500 | |
| (757) 460-2171 | |
| Not Available |
| Full Name | Mid-atlantic Family Practice |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 1020 Independence Blvd, Virginia Beach, Virginia |
| Authorized Official Name and Position | Michelle Elizabeth Kingsbury (OWNER) |
| Authorized Official Contact | 7574602171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-atlantic Family Practice 1020 Independence Blvd #103 Virginia Beach VA 23455-5500 Ph: (757) 460-2171 | Mid-atlantic Family Practice 1020 Independence Blvd #103 Virginia Beach VA 23455-5500 Ph: (757) 460-2171 |
| NPI Number | 1477766020 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 05/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477766020 | NPI | - | NPPES |
| CK8605 | Other | VA | MEDICARE RAILROAD |
| 292836 | Other | VA | ANTHEM BCBS |
| 298394 | Other | VA | MAMSI |
| 60522 | Other | OPTIMA | |
| 1669473260 | Other | VA | PROVIDER NPI |
| 2944020 | Other | VA | AETNA/US HEALTHCARE |
| 005645697 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | 0101047049 (Virginia) | Primary |
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