Chesapeake Medical Group
Organization Active NPI Family Medicine Physician · Reedville, VA
NPI 1700100583 · NPPES record last updated Aug 2, 2010
Key facts
- NPI
- 1700100583
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0101028388 (VA)
- Legal business name
- CHESAPEAKE MEDICAL GROUP
- Practice address
- 18682 Northumberland Hwy
Reedville, VA 22539-3411 - Phone
- (804) 453-4537
- Fax
- (804) 453-4317
- NPI assigned
- Mar 23, 2010
- Organization subpart
- No
Authorized official
- Name
- Mrs. Camille Pergola
- Title
- Administrative Assistant
- Phone
- (804) 435-8570
Corporate family (same tax ID) 1
Practitioners 4
-
Salvatore Karl Bavuso, M.D.
-
Wallace E Lewis, MD
National Provider Directory
- Tax ID family
- Chesapeake Medical Group
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 0101028388 | VA | Yes |
Addresses
Primary practice location
18682 Northumberland Hwy
Reedville, VA 22539-3411
Mailing address
PO Box 1328
Kilmarnock, VA 22482-1328
Phone (804) 435-8664
Other providers in Reedville, VA
- Acc Transportation LLC
- Debra M Cregger
- For the Ages Rehabilitation LLC
- Patricia A Fulcher
- Nancy Lee Holzshu
- Wallace E Lewis
All providers in Reedville, VA · Family Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.