| Virginia Advanced Medical Llc | |
|
300 Medical Pkwy Ste 306 Chesapeake VA 23320-4985 | |
| (757) 410-0672 | |
| Not Available |
| Full Name | Virginia Advanced Medical Llc |
|---|---|
| Speciality | General Practice |
| Location | 300 Medical Pkwy Ste 306, Chesapeake, Virginia |
| Authorized Official Name and Position | Jonathan Claar (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7574100672 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia Advanced Medical Llc 300 Medical Pkwy Ste 306 Chesapeake VA 23320-4985 Ph: (757) 410-0672 | Virginia Advanced Medical Llc 300 Medical Pkwy Ste 306 Chesapeake VA 23320-4985 Ph: (757) 410-0672 |
| NPI Number | 1093219131 |
|---|---|
| Provider Enumeration Date | 03/22/2018 |
| Last Update Date | 04/08/2020 |
| Medicare PECOS PAC ID | 1951635242 |
|---|---|
| Medicare Enrollment ID | O20190619003384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093219131 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Nicole Noble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306301726 PECOS PAC ID: 9931433224 Enrollment ID: I20190619003454 |
| Provider Name | Brian Crenshaw |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639464290 PECOS PAC ID: 0143441055 Enrollment ID: I20191204000675 |
| Provider Name | Tracy Arauza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588132435 PECOS PAC ID: 7214278407 Enrollment ID: I20210208000153 |
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