ELMER C SAN PEDRO (NPI# 1174532535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174532535 |
| Entity Type | Individual |
| Full Name | ELMER C SAN PEDRO |
| Credential | MD |
| Practice Address |
2204 Wilborn Ave South Boston VA 24592-1645 |
| Practice Telephone | 4345173187 |
| Practice Fax Number | 4345173686 |
| Mailing Telephone | 4345173403 |
| Mailing Fax Number | 4345173686 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
0101232533 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
2204 WILBORN AVE |
| City | SOUTH BOSTON |
| State | VA |
| Zip Code | 24592-1645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588668842 | Halifax Regional Hospital, Inc. | General Acute Care Hospital | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2005-06-02 |
| 1871058008 | Angeline Marie Davis | Nurse Anesthetist, Certified Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2019-02-01 |
| 1063931897 | Jon Michael Hughes | Nurse Practitioner | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-09-13 |
| 1265950646 | Mara Olivia Fiorio | Dietitian, Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-09-06 |
| 1942745526 | Alisyn L. Metz | Nurse Anesthetist, Certified Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-01-05 |
| 1255876835 | Andrew D. Metz | Nurse Anesthetist, Certified Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-01-05 |
| 1942743398 | Melaku Akele | Physical Therapist | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-12-01 |
| 1740730316 | Emily Silsby | Dietitian, Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-10-07 |
| 1023567153 | Mulbriar Emergency Physicians LLC | Physician Assistant | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-09-30 |
| 1205381621 | Banister River Emergency Physicians LLC | Physician Assistant | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966398 | Transformations Center for Health Wellness LLC | Counselor | 2170 Sandy Beach Road, South Boston, VA 24592 | 2019-11-12 |
| 1740830215 | Kirstyn Lokker | Occupational Therapist | 1 High School Circle, South Boston, South Boston, VA 24592 | 2019-09-17 |
| 1841764248 | Nicole Ivey | Occupational Therapy Assistant | 103 Rosehil Rd, South Boston, VA 24592 | 2019-01-18 |
| 1841700960 | Bio-medical Applications of Virginia, Inc. | Clinic/Center | 130 Aubreys Loop, South Boston, VA 24592 | 2017-10-03 |
| 1659828820 | Family Preservation Services, Inc | Community/Behavioral Health | 1 High School Circle, South Boston, VA 24592 | 2016-09-06 |
| 1316222821 | Family and Children Enrichment Services Inc. | Health Maintenance Organization | 220 Paradise Lane, South Boston, VA 24592 | 2011-10-15 |
| 1326365578 | Brinda Howard | Nurse's Aide | 104 Love Shop Park Rd Lot #25, South Boston, VA 24592 | 2010-04-28 |
| 1356513543 | Betts Medical Supplies, LLC. | Durable Medical Equipment & Medical Supplies | 403 Factory Street, Suite B, South Boston, VA 24592 | 2008-03-27 |
| 1407051873 | Dominion Health Medical Assoc | Legal Medicine | 101 Aubrey's Loop Rd, South Boston, VA 24592 | 2007-06-18 |
| 1437352945 | Behavioral Health Associates, Inc. | Non-emergency Medical Transport (VAN) | 515 Yancey Ave, South Boston, VA 24592 | 2007-06-11 |
| Find all providers in zip 24592 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821205832 | Arash Chehrazi | Radiology | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2007-05-17 |
| 1700945763 | Dennis Clark Stanley | Radiology | 2204 Wilborn Avenue, South Boston, VA 24592 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154928034 | Sentara Advanced Imaging Solutions, LLC | Radiology | 6201 E Virginia Beach Blvd Ste 104, Norfolk, VA 23502-2824 | 2020-10-05 |
| 1336623123 | Dominion Imaging LLC | Radiology | 6600 W Broad St Ste 200, Richmond, VA 23230-1709 | 2018-09-18 |
| 1851816680 | Washington Radiology Associates, Pllc | Radiology | 1005 N Glebe Rd Ste 110, Arlington, VA 22201-4751 | 2017-08-14 |
| 1992257497 | Ahmed Refaat Dakhly Mohamed | Radiology | 428 Monroe Ln, Apt 206, Charlottesville, VA 22903-3325 | 2016-10-31 |
| 1497140644 | Eric Young You | Radiology | Pob 980615, 1250 E. Marshall St, Richmond, VA 23298-0615 | 2015-04-04 |
| 1073903688 | Shelby Jean Galloway | Radiology | 12709 Willow Pt. Dr., Fredericksburg, VA 22408 | 2015-02-03 |
| 1740692581 | Charles Manetz | Radiology | 14107 Mortemer Rd, Midlothian, VA 23113-6060 | 2014-05-28 |
| 1821338153 | Minutemen Radiology Inc | Radiology | 4551 Jefferson Pointe Ln, Suite # 5 ., Prince George, VA 23875-1478 | 2013-02-23 |
| 1154673713 | Waleed Ibrahim | Radiology | 4723 Commons Dr, Apt 304, Annandale, VA 22003-5066 | 2012-10-08 |
| 1992063234 | Gustavo A Elias | Radiology | 10401 Spotsylvania Ave Ste 203, Fredericksburg, VA 22408 | 2012-04-24 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BOSTON |
| Zip Code | 24592 |
Please comment or provide details below to improve the information on ELMER C SAN PEDRO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.