| Middle Peninsula Medical Center Inc | |
|
9184 Buckley Hall Rd Mathews VA 23109-2309 | |
| (804) 725-0100 | |
| (804) 725-3158 |
| Full Name | Middle Peninsula Medical Center Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9184 Buckley Hall Rd, Mathews, Virginia |
| Authorized Official Name and Position | Thomas L. Wathen (VICE PRESIDENT) |
| Authorized Official Contact | 8043847902 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Middle Peninsula Medical Center Inc Po Box 1498 Mathews VA 23109-1498 Ph: (804) 725-0100 | Middle Peninsula Medical Center Inc 9184 Buckley Hall Rd Mathews VA 23109-2309 Ph: (804) 725-0100 |
| NPI Number | 1275085599 |
|---|---|
| Provider Enumeration Date | 11/03/2016 |
| Last Update Date | 11/04/2016 |
| Medicare PECOS PAC ID | 0143502898 |
|---|---|
| Medicare Enrollment ID | O20170113000281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275085599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Christian F Wathen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457384232 PECOS PAC ID: 9830179308 Enrollment ID: I20070511000082 |
| Provider Name | Leah Hurst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912538182 PECOS PAC ID: 9436580750 Enrollment ID: I20200520001647 |
| Provider Name | Kimberly Burnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720304967 PECOS PAC ID: 3274665070 Enrollment ID: I20200706000860 |
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