| Neruology Clinic - Bon Secours Medical Group | |
|
11601 Iron Bridge Rd Suite 207 Chester VA 23831-1466 | |
| (804) 285-6880 | |
| (804) 706-1585 |
| Full Name | Neruology Clinic - Bon Secours Medical Group |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 11601 Iron Bridge Rd, Chester, Virginia |
| Authorized Official Name and Position | Kimberly M Ralston (SYSTEM DIRECTOR) |
| Authorized Official Contact | 4199965119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neruology Clinic - Bon Secours Medical Group 8580 Magellan Pkwy Richmond VA 23227-1149 Ph: () - | Neruology Clinic - Bon Secours Medical Group 11601 Iron Bridge Rd Suite 207 Chester VA 23831-1466 Ph: (804) 285-6880 |
| NPI Number | 1013143635 |
|---|---|
| Provider Enumeration Date | 06/10/2009 |
| Last Update Date | 05/05/2022 |
| Certification Date | 05/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013143635 | NPI | - | NPPES |
| C09633 | Other | VA | MEDICARE GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 0101235914 (Virginia) | Primary |
| 305R00000X | Preferred Provider Organization | 0101235914 (Virginia) | Secondary |
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