# KIDMED SOUTHSIDE PLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KIDMED INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1477869337
- **Legal business name:** KIDMED INC
- **Authorized official:** DR. MARK ADAM FLANZENBAUM M.D. (PRESIDENT/MANAGING PARTNER)
- **Authorized official phone:** (804) 592-5437

## Contact information

- **Practice address:** 5021 CRAIG RATH BLVD, BLDG IV, MIDLOTHIAN, VA 23112-6243
- **Practice address phone:** (804) 422-5437
- **Practice address fax:** (804) 422-5438
- **Mailing address:** 4687 POUNCEY TRACT RD, GLEN ALLEN, VA 23059-5802
- **Mailing address phone:** (804) 422-5437
- **Mailing address fax:** (804) 422-5438

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/28/2010
- **Last updated:** 08/28/2023