Provider Demographics
NPI:1497853683
Name:ARTHRITIS AND RHEUMATIC DISEASES
Entity Type:Organization
Organization Name:ARTHRITIS AND RHEUMATIC DISEASES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:F
Authorized Official - Last Name:FLAGG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-220-8579
Mailing Address - Street 1:329 MCLAWS CIR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-6337
Mailing Address - Country:US
Mailing Address - Phone:757-220-8579
Mailing Address - Fax:757-345-0936
Practice Address - Street 1:329 MCLAWS CIR
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-6337
Practice Address - Country:US
Practice Address - Phone:757-220-8579
Practice Address - Fax:757-345-0936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058959207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA142097OtherANTHEM
VA5877741Medicaid
VA6083862Medicaid
VA21290OtherCIGNA HEALTHCARE
VA55110OtherSENTARA OPTIMA HEALTH
VA58854OtherSENTARA OPTIMA HEALTH
VA142096OtherANTHEM
VA2815503001OtherCIGNA HEALTHCARE
VA7781237Medicaid
VA110001434Medicare ID - Type Unspecified
VA0514960002Medicare NSC
VA142097OtherANTHEM
VAH68592Medicare UPIN
VA110016288Medicare PIN
VA55110OtherSENTARA OPTIMA HEALTH
VA7781237Medicaid