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2809 Emerywood Pkwy Ste 330-e Henrico VA 23294-3730 | |
| (804) 206-9660 | |
| (804) 206-9660 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2809 Emerywood Pkwy Ste 330-e, Henrico, Virginia |
| Authorized Official Name and Position | Keziah Mariae Del Rosario (OWNER) |
| Authorized Official Contact | 8042069660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2809 Emerywood Pkwy Ste 330-e Henrico VA 23294-3730 Ph: (804) 206-9660 | 2809 Emerywood Pkwy Ste 330-e Henrico VA 23294-3730 Ph: (804) 206-9660 |
| NPI Number | 1235961376 |
|---|---|
| Provider Enumeration Date | 08/16/2024 |
| Last Update Date | 10/01/2024 |
| Medicare PECOS PAC ID | 0143753186 |
|---|---|
| Medicare Enrollment ID | O20241029001848 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235961376 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Philip P Valmores |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063773778 PECOS PAC ID: 7618295239 Enrollment ID: I20150817000055 |
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