| Renee Burdett, Md Pc | |
|
13649 Office Place Suite 102 Woodbridge VA 22192 | |
| (703) 670-5738 | |
| (703) 670-8213 |
| Full Name | Renee Burdett, Md Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13649 Office Place, Woodbridge, Virginia |
| Authorized Official Name and Position | V Renee Burdett (MEDICAL DIRECTOR CEO) |
| Authorized Official Contact | 7036705738 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renee Burdett, Md Pc 13649 Office Place Suite 102 Woodbridge VA 22192 Ph: (703) 670-5738 | Renee Burdett, Md Pc 13649 Office Place Suite 102 Woodbridge VA 22192 Ph: (703) 670-5738 |
| NPI Number | 1760540967 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 02/03/2020 |
| Certification Date | 02/03/2020 |
| Medicare PECOS PAC ID | 2264583764 |
|---|---|
| Medicare Enrollment ID | O20090623000572 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760540967 | NPI | - | NPPES |
| Provider Name | James J Crist |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528138914 PECOS PAC ID: 5496870644 Enrollment ID: I20100913000334 |
| Provider Name | Verna R Burdett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821168212 PECOS PAC ID: 1557412061 Enrollment ID: I20101119000898 |
| Provider Name | Rachel G Ehrmantraut |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356711642 PECOS PAC ID: 6002113628 Enrollment ID: I20160328000532 |
| Provider Name | Hui Kuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255903712 PECOS PAC ID: 5597160150 Enrollment ID: I20210819000920 |
| Provider Name | Latoya D Cheatham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134531569 PECOS PAC ID: 8022534791 Enrollment ID: I20250424003651 |
| Provider Name | Sam L Bowmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770842585 PECOS PAC ID: 0648796862 Enrollment ID: I20250430001048 |
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