| Eudoc Pllc | |
|
1520 Huguenot Rd Ste 114 Midlothian VA 23113-2477 | |
| (804) 372-3461 | |
| Not Available |
| Full Name | Eudoc Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1520 Huguenot Rd Ste 114, Midlothian, Virginia |
| Authorized Official Name and Position | Kenneth Deng Qiu (OWNER) |
| Authorized Official Contact | 8043627307 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eudoc Pllc 14364 Altavista Blvd Midlothian VA 23114-6832 Ph: (703) 321-6386 | Eudoc Pllc 1520 Huguenot Rd Ste 114 Midlothian VA 23113-2477 Ph: (804) 372-3461 |
| NPI Number | 1326783226 |
|---|---|
| Provider Enumeration Date | 05/04/2022 |
| Last Update Date | 05/11/2022 |
| Medicare PECOS PAC ID | 8123400272 |
|---|---|
| Medicare Enrollment ID | O20220805001014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326783226 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Mariana Keener |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144726399 PECOS PAC ID: 6800145475 Enrollment ID: I20200716001345 |
| Provider Name | Kenneth D Qiu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780171850 PECOS PAC ID: 5991058604 Enrollment ID: I20200801000016 |
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