| Modern Richmond Endocrinology, Llc | |
|
1467 Johnston Willis Dr North Chesterfield VA 23235-4730 | |
| (804) 267-6920 | |
| (804) 267-6921 |
| Full Name | Modern Richmond Endocrinology, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1467 Johnston Willis Dr, North Chesterfield, Virginia |
| Authorized Official Name and Position | Leanza Liu (PRESIDENT) |
| Authorized Official Contact | 8042676920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Richmond Endocrinology, Llc 1467 Johnston Willis Dr North Chesterfield VA 23235-4730 Ph: (804) 267-6920 | Modern Richmond Endocrinology, Llc 1467 Johnston Willis Dr North Chesterfield VA 23235-4730 Ph: (804) 267-6920 |
| NPI Number | 1447614920 |
|---|---|
| Provider Enumeration Date | 04/11/2016 |
| Last Update Date | 06/01/2020 |
| Medicare PECOS PAC ID | 1951690452 |
|---|---|
| Medicare Enrollment ID | O20160524000504 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447614920 | NPI | - | NPPES |
| 0101247055 | Other | VA | STATE BOARD LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 0101247055 (Virginia) | Primary |
| Provider Name | Leanza H Liu |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1215105135 PECOS PAC ID: 7810175833 Enrollment ID: I20110622000332 |
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