Riverside Physician Services INC
Orthopaedic Surgery in Newport News, VA. Organization (NPI-2).
NPI number1609020643
StatusActive
Last updated in NPPESAug 10, 2021
Details
- NPI
- 1609020643
- Entity type
- Organization (NPI-2)
- Legal business name
- Riverside Physician Services INC
- Organization subpart
- Yes
- Enumeration date
- Nov 4, 2008
- Certification date
- Aug 10, 2021
- Last updated
- Aug 10, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | – | – | Yes |
| 207R00000X | Internal Medicine | – | VA | |
| 207RS0010X | Internal Medicine, Sports Medicine | – | – | |
| 207XX0005X | Orthopaedic Surgery, Sports Medicine | – | – | |
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – |
Other names
- Long Term Acute Care Hospital (Doing Business As)
Practice location
12200 Warwick Blvd Ste 490aNewport News, VA 23601-2548
Phone 757-534-9988 · Fax 757-594-3653
Mailing address
856 J Clyde Morris BlvdSuite A
Newport News, VA 23601-1318
Phone 757-316-5800 · Fax 757-534-5190
Authorized official
Braden Miller
Cfo
7573165906
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