Provider Demographics
NPI:1851492748
Name:VIRGINIA PHYSICIANS, INC
Entity Type:Organization
Organization Name:VIRGINIA PHYSICIANS, INC
Other - Org Name:COLD HARBOR FAMILY MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:MANGUM
Authorized Official - Last Name:DOBLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-730-1111
Mailing Address - Street 1:7255 HANOVER GREEN DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-1706
Mailing Address - Country:US
Mailing Address - Phone:804-730-1111
Mailing Address - Fax:804-730-9764
Practice Address - Street 1:7255 HANOVER GREEN DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-1706
Practice Address - Country:US
Practice Address - Phone:804-730-1111
Practice Address - Fax:804-730-9764
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIRGINIA PHYSICIANS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-26
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC05735Medicare PIN