Fitzgerald Marcelin (NPI# 1285818229, PAC ID# 0244392660) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1285818229 |
| PAC ID by PECOS | 0244392660 |
| Professional Enrollment ID | I20081218000757 |
| Full Name | Fitzgerald Marcelin |
| Organization Legal Name | SOUTHERN DOMINION HEALTH SYSTEM, INC. |
| Address |
13855 Courthouse Rd Dinwiddie VA 23841-2254 |
| Phone Number | 8044693731 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF PENNSYLVANIA |
| Graduation Year | 1997 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | PEDIATRIC MEDICINE |
| Group Practice PAC ID | 0648188755 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490097 | SOUTHERN VIRGINIA REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 13855 Courthouse Rd, Dinwiddie, VA 23841-2254 | 8044693731 | SOUTHERN DOMINION HEALTH SYSTEM, INC. |
| 727 N Main St, Emporia, VA 23847-1274 | 2406862300 | EMERGENCY MEDICINE ASSOCIATES PA PC |
| Organization Legal Name | SOUTHERN DOMINION HEALTH SYSTEM, INC. |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda L Russell | Family Medicine | Southern Dominion Health System, Inc. | 13855 Courthouse Rd, Dinwiddie, VA 23841-2254 |
| Margaret K Inge | Family Medicine | Southern Dominion Health System, Inc. | 8920 Otterburn Rd, Amelia Court House, VA 23002-4854 |
| Lisa M York | Family Medicine | Southern Dominion Health System, Inc. | 1508 K V Rd, Victoria, VA 23974-2624 |
| Margaret R Campbell | Pediatric Medicine | Southern Dominion Health System, Inc. | 8920 Otterburn Rd, Amelia Court House, VA 23002-4854 |
| Shannon L Rakes | Clinical Social Worker | Southern Dominion Health System, Inc. | 1508 K V Rd, Victoria, VA 23974-2624 |
| Hyo Kwon Park | Family Medicine | Southern Dominion Health System, Inc. | 13855 Courthouse Rd, Dinwiddie, VA 23841-2254 |
| John A Holland | Family Medicine | Southern Dominion Health System, Inc. | 1508 K V Rd, Victoria, VA 23974-2624 |
| Debra M Sequeira | Family Medicine | Southern Dominion Health System, Inc. | 8920 Otterburn Rd, Amelia Court House, VA 23002-4854 |
| Street Address |
13855 COURTHOUSE RD |
| City | DINWIDDIE |
| State | VA |
| Zip | 23841-2254 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda L Russell | Family Medicine | Southern Dominion Health System, Inc. | 13855 Courthouse Rd, Dinwiddie, VA 23841-2254 |
| Hyo Kwon Park | Family Medicine | Southern Dominion Health System, Inc. | 13855 Courthouse Rd, Dinwiddie, VA 23841-2254 |
| City | DINWIDDIE |
| Zip Code | 23841 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | DINWIDDIE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Fitzgerald Marcelin.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.