Organization
PRIMEDOC OF RICHMOND PC
Active
Organization
PRIMEDOC OF RICHMOND PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT REYNOLDS MD (PRESIDENT)
(828) 210-3260
Entity
Organization
Contact information
Practice address
1500 N 28TH ST, RICHMOND, VA 23223-5332
(804) 225-1701
Mailing address
PO BOX 60446, CHARLOTTE, NC 28260-0446
(828) 210-3260
(828) 255-7623
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136990
BLUE CROSS BLUE SHIELD
VA
01
—
DA9725
RAILROAD MEDICARE
VA
Enumeration date
07/17/2009
Last updated
07/17/2009
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