Provider Demographics
NPI:1780023994
Name:PEDIATRIC PARTNERS OF VIRGINIA, LLC
Entity Type:Organization
Organization Name:PEDIATRIC PARTNERS OF VIRGINIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMEJA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:804-464-2018
Mailing Address - Street 1:9020 STONY POINT PKWY STE 165
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1960
Mailing Address - Country:US
Mailing Address - Phone:804-464-2018
Mailing Address - Fax:804-464-2535
Practice Address - Street 1:9020 STONY POINT PKWY STE 165
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1960
Practice Address - Country:US
Practice Address - Phone:804-364-4400
Practice Address - Fax:804-364-0120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty