| Aloha Doctora Medicine, Llc | |
|
1770 N Parham Rd Ste 100 Richmond VA 23229-4658 | |
| (804) 665-5457 | |
| Not Available |
| Full Name | Aloha Doctora Medicine, Llc |
|---|---|
| Speciality | Pediatrics |
| Location | 1770 N Parham Rd Ste 100, Richmond, Virginia |
| Authorized Official Name and Position | Usama Samaan (PRESIDENT) |
| Authorized Official Contact | 8046655457 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aloha Doctora Medicine, Llc 1770 N Parham Rd Ste 100 Richmond VA 23229-4658 Ph: (804) 665-5457 | Aloha Doctora Medicine, Llc 1770 N Parham Rd Ste 100 Richmond VA 23229-4658 Ph: (804) 665-5457 |
| NPI Number | 1588339766 |
|---|---|
| Provider Enumeration Date | 08/10/2021 |
| Last Update Date | 08/03/2022 |
| Medicare PECOS PAC ID | 8921494204 |
|---|---|
| Medicare Enrollment ID | O20220414000038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588339766 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
| Provider Name | Usama Samaan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124316211 PECOS PAC ID: 7416250519 Enrollment ID: I20160125000354 |
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