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Organization
BON SECOURS DEPAUL MEDICAL CENTER INC
Active
Organization
BON SECOURS DEPAUL MEDICAL CENTER INC
Active
Other names
East Beach Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHAN QUIRICONI (CFO)
(804) 281-8301
Entity
Organization
Contact information
Practice address
4241 E LITTLE CREEK RD, NORFOLK, VA 23518-3546
(757) 738-1200
(757) 480-3208
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(804) 627-5462
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06209
GROUP PTAN
VA
Enumeration date
10/09/2013
Last updated
05/16/2019
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