| Obici Medical Management Services, Inc | |
|
1548 Holland Rd # B Suffolk VA 23434-6528 | |
| (757) 925-0706 | |
| (757) 539-4750 |
| Full Name | Obici Medical Management Services, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1548 Holland Rd # B, Suffolk, Virginia |
| Authorized Official Name and Position | William A Carpenter (SRVP-CFO) |
| Authorized Official Contact | 7579344000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Obici Medical Management Services, Inc 1548 Holland Rd # B Suffolk VA 23434-6528 Ph: (757) 925-0706 | Obici Medical Management Services, Inc 1548 Holland Rd # B Suffolk VA 23434-6528 Ph: (757) 925-0706 |
| NPI Number | 1962429498 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962429498 | NPI | - | NPPES |
| 323793 | Other | VA | ANTHEM |
| 263206 | Other | VA | OPTIMA |
| 41033 | Other | VA | SENTARA OPTIMA |
| 5632081 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101018926 (Virginia) | Primary |
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