Organization
RIVERSIDE PHYSICIAN SERVICES INC
Active
Parent organization
RIVERSIDE PHYSICIAN SERVICES INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIVERSIDE PHYSICIAN SERVICES INC
Authorized official
BRADEN MILLER MD (CFO)
(757) 316-5900
Entity
Organization
Contact information
Practice address
7552 HOSPITAL DR STE 302, GLOUCESTER, VA 23061-4178
(804) 693-6720
(804) 693-9875
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
(757) 594-4006
(757) 534-5190
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
VA
Other
Enumeration date
10/29/2008
Last updated
03/17/2018
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