Organization
RIVERSIDE PHYSICIAN SERVICES INC
Active
Parent organization
RIVERSIDE HEALTHCARE ASSOC
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIVERSIDE HEALTHCARE ASSOC
Authorized official
BRADEN MILLER (CFO)
(757) 316-5960
Entity
Organization
Contact information
Practice address
7554 HOSPITAL DR, SUITE 303, GLOUCESTER, VA 23061-4178
(757) 534-5340
(757) 594-3456
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
(757) 316-5960
(757) 534-5190
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
09/06/2007
Last updated
09/07/2016
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