| Bon Secours Liver Institute Of Hampton Roads | |
|
12720 Mcmanus Blvd Ste 313 Newport News VA 23602-4414 | |
| (757) 947-3190 | |
| (757) 947-3195 |
| Full Name | Bon Secours Liver Institute Of Hampton Roads |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 12720 Mcmanus Blvd Ste 313, Newport News, 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 |
|---|---|
| Bon Secours Liver Institute Of Hampton Roads 8580 Magellan Pkwy Richmond VA 23227-1149 Ph: (804) 627-5462 | Bon Secours Liver Institute Of Hampton Roads 12720 Mcmanus Blvd Ste 313 Newport News VA 23602-4414 Ph: (757) 947-3190 |
| NPI Number | 1013439835 |
|---|---|
| Provider Enumeration Date | 07/13/2017 |
| Last Update Date | 05/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013439835 | NPI | - | NPPES |
| C05149 | Other | VA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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