Organization
RIVERSIDE PHYSICIAN SERVICES INC
Active
Parent organization
RIVERSIDE HEALTHCARE ASSOCIATES
Other names
Riverside Medical Group - Shore
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIVERSIDE HEALTHCARE ASSOCIATES
Authorized official
BRADEN MILLER (CFO)
(757) 316-5800
Entity
Organization
Contact information
Practice address
20486 MARKET STREET, ONANCOCK, VA 23417
(757) 302-2700
(757) 787-9262
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
207Q00000X
Family Medicine Physician
—
VA
207RC0000X
Cardiovascular Disease Physician
—
VA
207RG0100X
Gastroenterology Physician
—
VA
207RP1001X
Pulmonary Disease Physician
—
VA
207T00000X
Neurological Surgery Physician
—
VA
207V00000X
Obstetrics & Gynecology Physician
—
VA
207X00000X
Orthopaedic Surgery Physician
—
VA
208600000X
Surgery Physician
Primary
—
VA
213E00000X
Podiatrist
—
VA
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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