Provider Demographics
NPI:1841997822
Name:PEDIATRIC PARTNERS OF VIRGINIA
Entity type:Organization
Organization Name:PEDIATRIC PARTNERS OF VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE OPERATIONS MGR
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMEJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-464-2018
Mailing Address - Street 1:P.O. BOX 76354
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4735
Mailing Address - Country:US
Mailing Address - Phone:804-464-2018
Mailing Address - Fax:804-464-2535
Practice Address - Street 1:1583 STANDING RIDGE DR
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-8051
Practice Address - Country:US
Practice Address - Phone:804-464-2018
Practice Address - Fax:804-464-2535
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEDIATRIC PARTNERS OF VIRGINIA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty