| Professional Place Medical Group, Llc | |
|
932 Professional Pl #201 Chesapeake VA 23320-3631 | |
| (757) 481-9406 | |
| (757) 389-5889 |
| Full Name | Professional Place Medical Group, Llc |
|---|---|
| Speciality | General Practice |
| Location | 932 Professional Pl, Chesapeake, Virginia |
| Authorized Official Name and Position | Richard Craven (MEMBER/OWNER) |
| Authorized Official Contact | 7574819406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Place Medical Group, Llc 932 Professional Pl #201 Chesapeake VA 23320-3631 Ph: (757) 481-9406 | Professional Place Medical Group, Llc 932 Professional Pl #201 Chesapeake VA 23320-3631 Ph: (757) 481-9406 |
| NPI Number | 1114937372 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114937372 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 0101037215 (Virginia) | Primary |
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