Alphonzo Jamiele Smalls (NPI# 1861751372, PAC ID# 2466438767) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1861751372 |
| PAC ID by PECOS | 2466438767 |
| Professional Enrollment ID | I20151231001805 |
| Full Name | Alphonzo Jamiele Smalls |
| Organization Legal Name | TIDEWATER MEDICAL CARE PC |
| Address |
109 Wimbledon Square G1 Chesapeake VA 23320-4945 |
| Phone Number | 7579659465 |
| Gender | M |
| Graduation Year | 2015 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 9133271661 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490007 | SENTARA NORFOLK GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 109 Wimbledon Square, G1, Chesapeake, VA 23320-4945 | 7579659465 | TIDEWATER MEDICAL CARE PC |
| 109 Wimbledon Square, Chesapeake, VA 23320-4945 | 7579659465 | TIDEWATER MEDICAL CARE PC |
| Organization Legal Name | TIDEWATER MEDICAL CARE PC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Judi Griffin | Internal Medicine | Tidewater Medical Care PC | 109 Wimbledon Square, G1, Chesapeake, VA 23320-4945 |
| Brandy Dantonio | Nurse Practitioner | Tidewater Medical Care PC | 109 Wimbledon Square, G1, Chesapeake, VA 23320-4945 |
| Migdonia Montejo | Family Medicine | Tidewater Medical Care PC | 109 Wimbledon Square, G1, Chesapeake, VA 23320-4945 |
| Angela Montejo | Physician Assistant | Tidewater Medical Care PC | 109 Wimbledon Square, Chesapeake, VA 23320-4945 |
| Street Address |
109 WIMBLEDON SQUARE G1 |
| City | CHESAPEAKE |
| State | VA |
| Zip | 23320-4945 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Judi Griffin | Internal Medicine | Tidewater Medical Care PC | 109 Wimbledon Square, G1, Chesapeake, VA 23320-4945 |
| Thomas W Montag | Gynecological Oncology | 109 Wimbledon Square, Suite F, Chesapeake, VA 23320-4945 | |
| Brandy Dantonio | Nurse Practitioner | Tidewater Medical Care PC | 109 Wimbledon Square, G1, Chesapeake, VA 23320-4945 |
| Migdonia Montejo | Family Medicine | Tidewater Medical Care PC | 109 Wimbledon Square, G1, Chesapeake, VA 23320-4945 |
| Angela Montejo | Physician Assistant | Tidewater Medical Care PC | 109 Wimbledon Square, Chesapeake, VA 23320-4945 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Khadijah Y Jordan | Obstetrics/gynecology | 111 Medical Pkwy, Suite 202, Chesapeake, VA 23320-0303 | |
| Krishna Brahma Sastry Topalli | Physical Medicine and Rehabilitation | 676 Battlefield Blvd, Suite B, Chesapeake, VA 23320-0306 | |
| Christopher C Fusco | Optometry | 812 Eden Way N, Chesapeake, VA 23320-0602 | |
| William L Mulligan | Psychologist, Clinical | William L Mulligan Phd PC | 1403 Greenbrier Pkwy, Suite 215, Chesapeake, VA 23320-0608 |
| Hannah Whitney Jones | Psychologist, Clinical | William L Mulligan Phd PC | 1403 Greenbrier Pkwy, Suite 215, Chesapeake, VA 23320-0608 |
| Brittany Lynn Montes | Psychologist, Clinical | William L Mulligan Phd PC | 1403 Greenbrier Pkwy, Suite 215, Chesapeake, VA 23320-0608 |
| Samantha L Zbur | Psychologist, Clinical | William L Mulligan Phd PC | 1403 Greenbrier Pkwy, Suite 215, Chesapeake, VA 23320-0608 |
| Cara Zuccarelli Eggers | Psychiatry | William L Mulligan Phd PC | 1403 Greenbrier Pkwy, Suite 215, Chesapeake, VA 23320-0608 |
| Bogdan Grynyk | Optometry | Myeyedr Optometry of Virginia, Pllc | 1401 Greenbrier Pkwy, Suite 1150, Chesapeake, VA 23320-0695 |
| Beth Winke | Interventional Pain Management | Winke Orthopedic Pain Management Center | 808 Eden Way N, Suite 102, Chesapeake, VA 23320-0745 |
| Find all physicians in zip 23320 | |||
| City | CHESAPEAKE |
| Zip Code | 23320 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | CHESAPEAKE + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Alphonzo Jamiele Smalls.
| 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.