| Premier Primary Care, Plc | |
|
113 Gainsborough Sq Ste 201 Chesapeake VA 23320-1714 | |
| (757) 410-8745 | |
| (757) 410-8746 |
| Full Name | Premier Primary Care, Plc |
|---|---|
| Speciality | Internal Medicine |
| Location | 113 Gainsborough Sq Ste 201, Chesapeake, Virginia |
| Authorized Official Name and Position | Dipes K Ray (M.D.) |
| Authorized Official Contact | 7574108745 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Primary Care, Plc 113 Gainsborough Sq Ste 201 Chesapeake VA 23320-1714 Ph: (757) 410-8745 | Premier Primary Care, Plc 113 Gainsborough Sq Ste 201 Chesapeake VA 23320-1714 Ph: (757) 410-8745 |
| NPI Number | 1790880623 |
|---|---|
| Provider Enumeration Date | 09/14/2006 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790880623 | NPI | - | NPPES |
| 1109507 | Other | FIRST HEALTH | |
| 173326 / 173327 | Other | ANTHEM | |
| 2182480 | Other | FIRST HEALTH | |
| 91697 | Other | OPTIMA | |
| P00099937 | Other | VA | RAILROAD MEDICARE |
| 0007777515 | Other | AETNA | |
| 114879 / 114964 | Other | ANTHEM | |
| 3342321 | Other | CIGNA | |
| 70343 | Other | OPTIMA | |
| 7596518 | Other | CIGNA | |
| 7687230 | Other | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | H82305 (Virginia) | Secondary |
| 207R00000X | Internal Medicine | G66860 (Virginia) | Primary |
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