Organization
IMMEDIATE MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVRA SIROT (MD)
(804) 405-2277
Entity
Organization
Contact information
Practice address
2038 JOHN ROLFE PKWY, RICHMOND, VA 23238-8111
(804) 288-7400
(804) 288-7460
Mailing address
9510 GAYTON RD, RICHMOND, VA 23229-5320
(804) 405-2277
(804) 288-7460
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101230936
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010067511
VA PREMIER PLAN
VA
05
—
010067979
—
VA
01
—
138520
BLUE CROSS BLUE SHIELD
VA
01
—
1464653
CIGNA
VA
01
—
239445
SOUTHERN HEALTH
VA
01
—
3470405
AETNA
VA
Enumeration date
04/06/2007
Last updated
06/06/2009
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