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Organization

KIDMED SOUTHSIDE PLC

Active
Parent organization
KIDMED INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
KIDMED INC
Authorized official
DR. MARK ADAM FLANZENBAUM M.D. (PRESIDENT/MANAGING PARTNER)
(804) 592-5437
Entity
Organization

Contact information

Practice address
5021 CRAIG RATH BLVD, BLDG IV, MIDLOTHIAN, VA 23112-6243
(804) 422-5437
(804) 422-5438
Mailing address
4687 POUNCEY TRACT RD, GLEN ALLEN, VA 23059-5802
(804) 422-5437
(804) 422-5438

Taxonomy

Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary

Other

Enumeration date
08/28/2010
Last updated
08/28/2023
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