| Dr Redouane Goulmamine, MD | |
|
95 Medical Park Blvd, Petersburg, VA 23805-9280 | |
| (804) 504-8100 | |
| (804) 504-7795 |
| Full Name | Dr Redouane Goulmamine |
|---|---|
| Gender | Male |
| Speciality | Physical Medicine & Rehabilitation |
| Location | 95 Medical Park Blvd, Petersburg, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285636894 | NPI | - | NPPES |
| 345128 | Other | VA | ANTHEM |
| 7047613 | Other | VA | AETNA |
| 3639781 | Other | VA | CIGNA |
| 1285636894 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | 0101242555 (Virginia) | Primary |
| Entity Name | National Health Rehabilitation Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780080218 PECOS PAC ID: 4284952615 Enrollment ID: O20200212001804 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Redouane Goulmamine, MD 513 Heth Ct, Midlothian, VA 23114-5532 Ph: (804) 897-3455 | Dr Redouane Goulmamine, MD 95 Medical Park Blvd, Petersburg, VA 23805-9280 Ph: (804) 504-8100 |
Brian Michael Dena, D.O. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 95 Medical Park Blvd, Petersburg, VA 23805 Phone: 804-504-8100 | |
Sarah Combs, PTA Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 3201 Holland Dr, Petersburg, VA 23805 Phone: 540-426-8244 | |
Randolph Mitchell Jenkins Jr., M.D. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 95 Medical Park Blvd, Petersburg, VA 23805 Phone: 804-504-8100 |