Provider Demographics
NPI:1275696569
Name:PHYSICIAN ASSISTANT SERVICES INC
Entity Type:Organization
Organization Name:PHYSICIAN ASSISTANT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICIAN ASSISTANT
Authorized Official - Phone:757-496-6660
Mailing Address - Street 1:2132 CREEKS EDGE DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6804
Mailing Address - Country:US
Mailing Address - Phone:757-496-6660
Mailing Address - Fax:757-271-6550
Practice Address - Street 1:2132 CREEKS EDGE DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6804
Practice Address - Country:US
Practice Address - Phone:757-496-6660
Practice Address - Fax:757-271-6550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001748363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006637P84Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
VAC09384Medicare ID - Type UnspecifiedGROUP NUMBER