Organization
PRIMEDOC OF NORFOLK PC
Active
Organization
PRIMEDOC OF NORFOLK PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J REYNOLDS MD (PRESIDENT)
(828) 210-3260
Entity
Organization
Contact information
Practice address
150 KINGSLEY LN, NORFOLK, VA 23505-4602
(843) 237-3378
(843) 237-5073
Mailing address
PO BOX 601835, CHARLOTTE, NC 28260-1835
(843) 237-3378
(843) 237-5073
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588693725
—
VA
01
—
246875
BLUE SHIELD
VA
01
—
DF0829
RAILROAD MEDICARE
VA
Enumeration date
07/01/2006
Last updated
03/17/2009
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