| Olympia Family Medicine | |
|
14024 Wiley Cir Midlothian VA 23114-5578 | |
| (804) 639-8145 | |
| Not Available |
| Full Name | Olympia Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 14024 Wiley Cir, Midlothian, Virginia |
| Authorized Official Name and Position | Bernice Natalie Mucuis-penha (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8046398145 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Olympia Family Medicine 14024 Wiley Cir Midlothian VA 23114-5578 Ph: (804) 639-8145 | Olympia Family Medicine 14024 Wiley Cir Midlothian VA 23114-5578 Ph: (804) 639-8145 |
| NPI Number | 1235546201 |
|---|---|
| Provider Enumeration Date | 07/22/2014 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 2163745126 |
|---|---|
| Medicare Enrollment ID | O20141223001048 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235546201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101249977 (Virginia) | Primary |
| Provider Name | Bernice N Mucius Penha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568628527 PECOS PAC ID: 5193994549 Enrollment ID: I20110802000042 |
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