Samuel Holloway (NPI# 1023546256, PAC ID# 1850661521) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1023546256 |
| PAC ID by PECOS | 1850661521 |
| Professional Enrollment ID | I20170728000575 |
| Full Name | Samuel Holloway |
| Organization Legal Name | TIDEWATER PHYSICIANS MULTISPECIALTY GRP, PC |
| Address |
222 Grafton Dr Grafton VA 23692-2152 |
| Phone Number | 7578987737 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 2860398526 |
| Number of Group Practice Members | 217 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490041 | BON SECOURS MARY IMMACULATE HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 101 A York Crossing, Grafton, VA 23692 | 7578987737 | TIDEWATER PHYSICIANS MULTISPECIALTY GRP, PC |
| 222 Grafton Dr, Grafton, VA 23692-2152 | 7578987737 | TIDEWATER PHYSICIANS MULTISPECIALTY GRP, PC |
| 12695 Mcmanus Blvd, 6a, Newport News, VA 23602-4476 | 7579691755 | TIDEWATER PHYSICIANS MULTISPECIALTY GRP, PC |
| 12720 Mcmanus Blvd, Suite 201, Newport News, VA 23602-4486 | 7578755332 | TIDEWATER PHYSICIANS MULTISPECIALTY GRP, PC |
| 13195 Warwick Blvd, 2c, Newport News, VA 23602-8313 | 8048774221 | TIDEWATER PHYSICIANS MULTISPECIALTY GRP, PC |
| 13347 Warwick Blvd, Newport News, VA 23602-5601 | 8048774221 | TIDEWATER PHYSICIANS MULTISPECIALTY GRP, PC |
| 1405 Kiln Creek Pkwy K, Newport News, VA 23602-9700 | 7573695784 | TIDEWATER PHYSICIANS MULTISPECIALTY GRP, PC |
| 802 Lockwood Ave A, Newport News, VA 23602-4479 | 7578729797 | TIDEWATER PHYSICIANS MULTISPECIALTY GRP, PC |
| Organization Legal Name | TIDEWATER PHYSICIANS MULTISPECIALTY GRP, PC |
| Physicians | 16 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Patricia Parr | Physical Therapy | Tidewater Physicians Multispecialty Grp, PC | 132 Professional Cir, Williamsburg, VA 23185-3374 |
| Kelsey Velo | Physical Therapy | Tidewater Physicians Multispecialty Grp, PC | 860 Omni Blvd, Suite 103, Newport News, VA 23606-4430 |
| Eileen Boyle Vernon | Nurse Practitioner | Tidewater Physicians Multispecialty Grp, PC | 132 Professional Cir, Williamsburg, VA 23185-3374 |
| Maryam M Nowroozi | Internal Medicine | Tidewater Physicians Multispecialty Grp, PC | 13195 Warwick Blvd, 2c, Newport News, VA 23602-8313 |
| Shiela Marie Dinunzio | Physical Therapy | Tidewater Physicians Multispecialty Grp, PC | 860 Omni Blvd, Newport News, VA 23606-4430 |
| Joanne P Trimbur | Family Practice | Tidewater Physicians Multispecialty Grp, PC | 12655 Warwick Blvd A, Newport News, VA 23606-2501 |
| William H Polk | Internal Medicine | Tidewater Physicians Multispecialty Grp, PC | 13195 Warwick Blvd, 2c, Newport News, VA 23602-8313 |
| Ashley Tomco | Physical Therapy | Tidewater Physicians Multispecialty Grp, PC | 13347 Warwick Blvd, Newport News, VA 23602-5601 |
| Christopher Gemmer | Physician Assistant | Tidewater Physicians Multispecialty Grp, PC | 1100 Volvo Pkwy, Suite 100, Chesapeake, VA 23320-3341 |
| Rosetta Maria Fratiani | Nurse Practitioner | Tidewater Physicians Multispecialty Grp, PC | 860 Omni Blvd, Suite 202, Newport News, VA 23606-4430 |
| Street Address |
222 GRAFTON DR |
| City | GRAFTON |
| State | VA |
| Zip | 23692-2152 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephanie Barnes | Nurse Practitioner | Tidewater Physicians Multispecialty Group, PC | 222 Grafton Dr, Grafton, VA 23692-2152 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa M Perez | Clinical Social Worker | Colonial Behavioral Health | 3804 George Washington Memorial Hwy, Yorktown, VA 23692 |
| Gloria Jackson | Family Medicine | Tidewater Physicians Multispecialty Group, PC | 101 A York Crossing, Grafton, VA 23692 |
| Meghan Pollard | Nurse Practitioner | Tidewater Physicians Multispecialty Group, PC | 101 A York Crossing, Grafton, VA 23692 |
| Laura Bronstein | Clinical Social Worker | Hampton Roads Counseling Ctr Inc | 6515 Rt, Suite 17, Grafton, VA 23692-1069 |
| Gary Lee Baker | Clinical Social Worker | Hampton Roads Counseling Ctr Inc | 6515 Rt, Suite 17, Grafton, VA 23692-1069 |
| Catherine D Smithson | Clinical Social Worker | Hampton Roads Counseling Ctr Inc | 6515 Rt, Suite 17, Grafton, VA 23692-1069 |
| William J Shields | Dermatology | W J Shields M D | 914 Denbigh Blvd, Grafton, VA 23692-2156 |
| Lois W Shields | Nurse Practitioner | W J Shields M D | 914 Denbigh Blvd, Grafton, VA 23692-2156 |
| Kelly Neidiffer Bailey | Optometry | Zoe Inc. | 6515 George Washington Mem Hwy, Suite 102, Yorktown, VA 23692-2182 |
| Brenton L Burchett | Chiropractic | Gunderman Chiropractic and Wellness LLC | 5701 George Washington Mem Hwy, Yorktown, VA 23692-2773 |
| Find all physicians in zip 23692 | |||
| City | GRAFTON |
| Zip Code | 23692 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | GRAFTON + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Samuel Holloway.
| 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.