Provider Demographics
NPI:1801991427
Name:HOPEWELL ORTHOPAEDIC CENTER, INC
Entity type:Organization
Organization Name:HOPEWELL ORTHOPAEDIC CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BALJIT
Authorized Official - Middle Name:S
Authorized Official - Last Name:SIDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-530-0999
Mailing Address - Street 1:2 E HUNDRED RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2609
Mailing Address - Country:US
Mailing Address - Phone:804-530-0999
Mailing Address - Fax:804-530-0997
Practice Address - Street 1:2 E HUNDRED RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-2609
Practice Address - Country:US
Practice Address - Phone:804-530-0999
Practice Address - Fax:804-530-0997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101031126204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006408729Medicaid
VA1073580221OtherMEDICARE RAILROAD
VA1073580221OtherMEDICARE RAILROAD
VAC09578Medicare ID - Type UnspecifiedMEDICARE