| Indian River Family Practice Pc | |
|
1016 Justis St Chesapeake VA 23325 | |
| (757) 420-8297 | |
| (757) 523-5639 |
| Full Name | Indian River Family Practice Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1016 Justis St, Chesapeake, Virginia |
| Authorized Official Name and Position | Larry Howard Kagan (SECRETARY TREASURER) |
| Authorized Official Contact | 7574208297 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indian River Family Practice Pc 1016 Justis St Chesapeake VA 23325 Ph: (757) 420-8297 | Indian River Family Practice Pc 1016 Justis St Chesapeake VA 23325 Ph: (757) 420-8297 |
| NPI Number | 1629155122 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629155122 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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