Organization
RIVERSIDE PHYSICIAN SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADEN MILLER (CFO)
(757) 316-5900
Entity
Organization
Contact information
Practice address
659 HOSPITAL RD STE 101, TAPPAHANNOCK, VA 22560-7000
(804) 466-3270
(804) 466-3273
Mailing address
856 J CLYDE MORRIS BLVD STE A, NEWPORT NEWS, VA 23601-1318
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
08/03/2017
Last updated
08/03/2017
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