| Optima Health Plan | |
|
701 S Main St Norfolk VA 23523-1245 | |
| (757) 388-1830 | |
| (855) 939-7176 |
| Full Name | Optima Health Plan |
|---|---|
| Speciality | Family Medicine |
| Location | 701 S Main St, Norfolk, Virginia |
| Authorized Official Name and Position | Doris Prince (DIRECTOR) |
| Authorized Official Contact | 7579835475 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optima Health Plan 701 S Main St Norfolk VA 23523-1245 Ph: (757) 388-1830 | Optima Health Plan 701 S Main St Norfolk VA 23523-1245 Ph: (757) 388-1830 |
| NPI Number | 1679294201 |
|---|---|
| Provider Enumeration Date | 09/12/2022 |
| Last Update Date | 09/12/2022 |
| Medicare PECOS PAC ID | 1658736186 |
|---|---|
| Medicare Enrollment ID | O20230504003199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679294201 | NPI | - | NPPES |
| Provider Name | Michael G Charles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013982388 PECOS PAC ID: 3577543081 Enrollment ID: I20040724000085 |
| Provider Name | Amanda L Coyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518075399 PECOS PAC ID: 4587762604 Enrollment ID: I20211019001616 |
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