Organization
RIVERSIDE PHYSICIAN SERVICES INC
Active
Other names
Peninsula Surgical
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J DOUCETTE (VICE PRESIDENT)
(757) 594-4006
Entity
Organization
Contact information
Practice address
500 J CLYDE MORRIS BLVD, SUITE 601, NEWPORT NEWS, VA 23601-1929
(757) 534-5300
(757) 532-5316
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
(757) 594-4006
(757) 594-2195
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
12/12/2006
Last updated
10/31/2008
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