Organization
VIRGINIA EMERGENCY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER BRIAN DURHAM (PRESIDENT)
(770) 874-5400
Entity
Organization
Contact information
Practice address
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805
(804) 765-5000
Mailing address
5665 NEW NORTHSIDE DR, SUITE 320, ATLANTA, GA 30328-5831
(770) 847-5400
(770) 874-5483
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487816369
BCBS
VA
05
—
1487816369
—
VA
01
—
613604200
DOL
VA
01
—
DO3229
RR MEDICARE
VA
Enumeration date
07/01/2008
Last updated
03/03/2017
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