Organization
RIVERSIDE PHYSICIAN SERVICES INC
Active
Parent organization
RIVERSIDE HEALTHCARE ASSOC
Other names
RIVERSIDE RENAL SPECIALISTS
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
7552 HOSPITAL DR, SUITE 302, GLOUCESTER, VA 23061-4178
(804) 693-9062
(804) 694-0597
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
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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