Provider Demographics
NPI:1710012562
Name:SURGICAL SPECIALISTS OF RICHMOND
Entity Type:Organization
Organization Name:SURGICAL SPECIALISTS OF RICHMOND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:LAMPIE
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:804-559-0194
Mailing Address - Street 1:8262 ATLEE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-1816
Mailing Address - Country:US
Mailing Address - Phone:804-559-0194
Mailing Address - Fax:804-559-0198
Practice Address - Street 1:8262 ATLEE RD STE 205
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-1816
Practice Address - Country:US
Practice Address - Phone:804-559-0194
Practice Address - Fax:804-559-0198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACM4156OtherRAILROAD MEDICARE GROUP
VAC00847Medicare PIN