| Pleasant Valley Medical Center, Inc | |
|
4221 Pleasant Valley Rd Suite 114 Virginia Beach VA 23464-8519 | |
| (757) 495-7420 | |
| (757) 495-3917 |
| Full Name | Pleasant Valley Medical Center, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4221 Pleasant Valley Rd, Virginia Beach, Virginia |
| Authorized Official Name and Position | Abdur R Khan (PRESIDENT) |
| Authorized Official Contact | 7574957420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pleasant Valley Medical Center, Inc 4221 Pleasant Valley Rd Suite 114 Virginia Beach VA 23464-8519 Ph: (757) 495-7420 | Pleasant Valley Medical Center, Inc 4221 Pleasant Valley Rd Suite 114 Virginia Beach VA 23464-8519 Ph: (757) 495-7420 |
| NPI Number | 1295826071 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 02/13/2008 |
| Medicare PECOS PAC ID | 4688847536 |
|---|---|
| Medicare Enrollment ID | O20111109000589 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295826071 | NPI | - | NPPES |
| 330829 | Other | VA | BCBS |
| 330828 | Other | VA | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Virginia) | Primary |
| 208000000X | Pediatrics | (Virginia) | Secondary |
| Provider Name | Abdur R Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992766851 PECOS PAC ID: 8022281989 Enrollment ID: I20111109000627 |
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