# PROFESSIONAL PLACE MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** East Coast Clinical Research, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114937372
- **Authorized official:** DR. RICHARD CRAVEN MD (MEMBER/OWNER)
- **Authorized official phone:** (757) 481-9406

## Contact information

- **Practice address:** 932 PROFESSIONAL PL, \#201, CHESAPEAKE, VA 23320-3631
- **Practice address phone:** (757) 481-9406
- **Practice address fax:** (757) 389-5889
- **Mailing address:** 932 PROFESSIONAL PL, \#201, CHESAPEAKE, VA 23320-3631
- **Mailing address phone:** (757) 481-9406
- **Mailing address fax:** (757) 389-5889

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 0101037215 | VA | Yes |

## Other

- **Enumeration date:** 08/09/2006
- **Last updated:** 08/22/2020