Organization
RIVERSIDE PHYSICIAN SERVICES INC
Active
Other names
Riverside Premier Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J DOUCETTE (VICE PRESIDENT)
(757) 594-4006
Entity
Organization
Contact information
Practice address
111 BULIFANTS BLVD, SUITE B, WILLIAMSBURG, VA 23188-5711
(757) 221-0006
(757) 253-9418
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
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/15/2006
Last updated
08/22/2020
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