Organization
OPTIMA HEALTH PLAN
Active
Other names
SENTARA COMMUNITY CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS PRINCE (DIRECTOR)
(175) 798-3547
Entity
Organization
Contact information
Practice address
10800 NUCKOLS RD, GLEN ALLEN, VA 23060-6207
(804) 613-3940
(757) 440-3277
Mailing address
10800 NUCKOLS RD, GLEN ALLEN, VA 23060-6207
(804) 613-3940
(757) 440-3277
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
—
—
Other
Enumeration date
01/20/2023
Last updated
01/31/2023
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