Organization
OBICI MEDICAL MANAGEMENT SERVICES, INC
Active
Other names
Suffolk Family Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM A CARPENTER (SRVP-CFO)
(757) 934-4000
Entity
Organization
Contact information
Practice address
1548 HOLLAND RD # B, SUFFOLK, VA 23434-6528
(757) 925-0706
(757) 539-4750
Mailing address
1548 HOLLAND RD # B, SUFFOLK, VA 23434-6528
(757) 925-0706
(757) 539-4750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101018926
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
263206
OPTIMA
VA
01
—
323793
ANTHEM
VA
01
—
41033
SENTARA OPTIMA
VA
05
—
5632081
—
VA
Enumeration date
07/17/2006
Last updated
08/22/2020
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