# RIVERSIDE FAMILY MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467849349
- **Authorized official:** MARIUM MUJAHID (RESIDENT)
- **Authorized official phone:** (703) 314-4456

## Contact information

- **Practice address:** 10510 JEFFERSON AVE STE A, NEWPORT NEWS, VA 23601-3102
- **Practice address phone:** (757) 594-3800
- **Practice address fax:** (575) 594-3890
- **Mailing address:** 10510 JEFFERSON AVE STE A, NEWPORT NEWS, VA 23601-3102
- **Mailing address phone:** (757) 594-3800
- **Mailing address fax:** (575) 594-3890

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — | Yes |

## Other

- **Enumeration date:** 04/19/2015
- **Last updated:** 04/19/2015