Organization
CHESAPEAKE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAMILLE PERGOLA (ADMINISTRATIVE ASSISTANT)
(804) 435-8570
Entity
Organization
Contact information
Practice address
18682 NORTHUMBERLAND HWY, REEDVILLE, VA 22539-3411
(804) 453-4537
(804) 453-4317
Mailing address
PO BOX 1328, KILMARNOCK, VA 22482-1328
(804) 435-8664
(804) 435-8037
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101028388
VA
Other
Enumeration date
03/23/2010
Last updated
08/02/2010
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