Provider Demographics
NPI:1891857439
Name:VIRGINIA PHYSICIANS, INC.
Entity type:Organization
Organization Name:VIRGINIA PHYSICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDERIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-346-1507
Mailing Address - Street 1:PO BOX 28598
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-8598
Mailing Address - Country:US
Mailing Address - Phone:804-346-1507
Mailing Address - Fax:804-915-0035
Practice Address - Street 1:7702 E PARHAM RD
Practice Address - Street 2:SUITE 304
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4371
Practice Address - Country:US
Practice Address - Phone:804-346-1507
Practice Address - Fax:804-915-0035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA24129598363LA2100X
VA207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CB4718Medicare PIN
VAC06701Medicare PIN