| Lifeway Family Physicians Pc | |
|
1821 Old Donation Pkwy Suite #4 Virginia Beach VA 23454-3033 | |
| (757) 496-4916 | |
| (757) 496-4046 |
| Full Name | Lifeway Family Physicians Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1821 Old Donation Pkwy, Virginia Beach, Virginia |
| Authorized Official Name and Position | Deirdre Barnes (MANAGER) |
| Authorized Official Contact | 7574964916 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeway Family Physicians Pc 1821 Old Donation Pkwy Suite #4 Virginia Beach VA 23454-3033 Ph: (757) 496-4916 | Lifeway Family Physicians Pc 1821 Old Donation Pkwy Suite #4 Virginia Beach VA 23454-3033 Ph: (757) 496-4916 |
| NPI Number | 1972672731 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 04/09/2015 |
| Medicare PECOS PAC ID | 8921079492 |
|---|---|
| Medicare Enrollment ID | O20040805001541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972672731 | NPI | - | NPPES |
| 1205801719 | Other | VA | MEDICARE NUMBER |
| 080008247 | Other | VA | MEDICARE NUMBER |
| 1194806307 | Other | VA | MEDICARE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Dashiell Bakhshi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205801719 PECOS PAC ID: 2264458413 Enrollment ID: I20051018000548 |
| Provider Name | Brant Wayne Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730155862 PECOS PAC ID: 6709855521 Enrollment ID: I20100903000352 |
| Provider Name | Laura Rae Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922074079 PECOS PAC ID: 3072582899 Enrollment ID: I20100928001652 |
| Provider Name | Veronique D Duguay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174643803 PECOS PAC ID: 6002968328 Enrollment ID: I20130214000349 |
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