| Colonial Internal Medicine Associates Pc | |
|
125 Olde Greenwich Dr Suite 300 Fredericksburg VA 22408-4001 | |
| (540) 374-5599 | |
| (540) 735-8097 |
| Full Name | Colonial Internal Medicine Associates Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 125 Olde Greenwich Dr, Fredericksburg, Virginia |
| Authorized Official Name and Position | Kenneth M Mcdowell (PHYSICIAN OWNER) |
| Authorized Official Contact | 5403745599 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colonial Internal Medicine Associates Pc 125 Olde Greenwich Dr Suite 300 Fredericksburg VA 22408-4001 Ph: (540) 374-5599 | Colonial Internal Medicine Associates Pc 125 Olde Greenwich Dr Suite 300 Fredericksburg VA 22408-4001 Ph: (540) 374-5599 |
| NPI Number | 1346260940 |
|---|---|
| Provider Enumeration Date | 07/20/2006 |
| Last Update Date | 02/14/2008 |
| Medicare PECOS PAC ID | 6608842521 |
|---|---|
| Medicare Enrollment ID | O20040902000556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346260940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0102201579 (Virginia) | Primary |
| Provider Name | Kenneth M Mcdowell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306834379 PECOS PAC ID: 6507757416 Enrollment ID: I20040902000590 |
| Provider Name | Kristie E Mcdowell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1275574279 PECOS PAC ID: 5092751594 Enrollment ID: I20050706001020 |
| Provider Name | Cindy S Marrow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407842263 PECOS PAC ID: 3779687678 Enrollment ID: I20070403000141 |
| Provider Name | Bethanne H Elbert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447298880 PECOS PAC ID: 1153408109 Enrollment ID: I20080402000021 |
| Provider Name | Mary Ailis Aiken |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982709960 PECOS PAC ID: 6103984059 Enrollment ID: I20081021000498 |
| Provider Name | Bozena D Wolanska |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689660839 PECOS PAC ID: 1153455308 Enrollment ID: I20100810000930 |
| Provider Name | Gabriel Szmigiel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841462892 PECOS PAC ID: 5597925487 Enrollment ID: I20120330000267 |
| Provider Name | Juan C Munoz-gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588892236 PECOS PAC ID: 5799920963 Enrollment ID: I20130319000149 |
| Provider Name | William T Jordan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245668516 PECOS PAC ID: 7618106261 Enrollment ID: I20140131001422 |
| Provider Name | Michael Y Zhang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033119136 PECOS PAC ID: 1759423122 Enrollment ID: I20190124000520 |
| Provider Name | Abisoye V Fakayode |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225415227 PECOS PAC ID: 9436400892 Enrollment ID: I20200826001309 |
| Provider Name | Mary Beaven |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366117871 PECOS PAC ID: 9739579913 Enrollment ID: I20211201002750 |
| Provider Name | Manga Omasombo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316599012 PECOS PAC ID: 8921484403 Enrollment ID: I20230515000460 |
| Provider Name | Celeste R Keller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639604358 PECOS PAC ID: 2466818604 Enrollment ID: I20230515001181 |
| Provider Name | Elizabeth Allan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144477142 PECOS PAC ID: 5092141366 Enrollment ID: I20230815002000 |
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