Provider Demographics
NPI:1891965422
Name:PATRICIA L RAYMOND, M.D., PLLC
Entity Type:Organization
Organization Name:PATRICIA L RAYMOND, M.D., PLLC
Other - Org Name:SIMPLY SCREENING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RAYMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-523-9755
Mailing Address - Street 1:680 KINGSBOROUGH SQ
Mailing Address - Street 2:SUITE D
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4988
Mailing Address - Country:US
Mailing Address - Phone:757-464-1644
Mailing Address - Fax:757-363-1071
Practice Address - Street 1:680 KINGSBOROUGH SQ
Practice Address - Street 2:SUITE D
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4988
Practice Address - Country:US
Practice Address - Phone:757-523-9755
Practice Address - Fax:757-523-8600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101045459174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA105928OtherANTHEM
VA515366OtherMAMSI/OPTIMUM CHOICE/MDIPA
VA010050715Medicaid
VA15938OtherOPTIMA
VA3575971OtherCIGNA
VA105928OtherANTHEM
VA105928OtherANTHEM
VAC08981Medicare PIN