Gwendolyn L Riddick (NPI# 1164733580, PAC ID# 5496077661) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1164733580 |
| PAC ID by PECOS | 5496077661 |
| Professional Enrollment ID | I20150209001018 |
| Full Name | Gwendolyn L Riddick |
| Organization Legal Name | DOMINION HEALTH MEDICAL ASSOC |
| Address |
115 College St Clarksville VA 23927-9125 |
| Phone Number | 4343745344 |
| Gender | F |
| Graduation Year | 2010 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 1254311558 |
| Number of Group Practice Members | 45 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490013 | SENTARA HALIFAX REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 115 College St, Clarksville, VA 23927-9125 | 4343745344 | DOMINION HEALTH MEDICAL ASSOC |
| 2206 Wilborn Ave, South Boston, VA 24592-1630 | 4345178627 | DOMINION HEALTH MEDICAL ASSOC |
| Organization Legal Name | DOMINION HEALTH MEDICAL ASSOC |
| Physicians | 49 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jean M Minier | Nurse Practitioner | Dominion Health Medical Assoc | 15210 L P Bailey Memorial Hwy, Nathalie, VA 24577-3304 |
| Keysha D Ahmad-winborne | Nurse Practitioner | Dominion Health Medical Assoc | 946 N Main St, Chase City, VA 23924-1139 |
| Whitney H Wilborn | Nurse Practitioner | Dominion Health Medical Assoc | 101 Aubreys Loop, South Boston, VA 24592-5054 |
| Michelle B Gibson | Nurse Practitioner | Dominion Health Medical Assoc | 2232 Wilborn Ave, South Boston, VA 24592-1662 |
| Michael K Kyles | Orthopedic Surgery | Dominion Health Medical Assoc | 422 Hamilton Blvd, South Boston, VA 24592-5200 |
| Lovetta Pugh | General Surgery | Dominion Health Medical Assoc | 2212 Wilborn Ave, South Boston, VA 24592-1630 |
| Michelle M Grant | Certified Registered Nurse Anesthetist (crna) | Dominion Health Medical Assoc | 2204 Wilborn Ave, South Boston, VA 24592-1645 |
| Sameer S Alrefai | General Surgery | Dominion Health Medical Assoc | 2204 Wilborn Ave, South Boston, VA 24592-1645 |
| Fernando Gomez-rivera | Otolaryngology | Dominion Health Medical Assoc | 2232 Wilborn Ave, South Boston, VA 24592-1662 |
| Angelin B Comer | Nurse Practitioner | Dominion Health Medical Assoc | 15210 L P Bailey Memorial Hwy, Nathalie, VA 24577-3304 |
| Street Address |
115 COLLEGE ST |
| City | CLARKSVILLE |
| State | VA |
| Zip | 23927-9125 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony E Wilkerson | Nurse Practitioner | Dominion Health Medical Assoc | 115 College St, Clarksville, VA 23927-9125 |
| Kelly Arendall Hill | Nurse Practitioner | Dominion Health Medical Assoc | 115 College St, Clarksville, VA 23927-9125 |
| Carlos Pottinger | Obstetrics/gynecology | Dominion Health Medical Assoc | 115 College St, Clarksville, VA 23927-9125 |
| Charles W Rosche | Obstetrics/gynecology | Dominion Health Medical Assoc | 115 College St, Clarksville, VA 23927-9125 |
| Jill Burmeister Allen | Family Practice | Dominion Health Medical Assoc | 115 College St, Clarksville, VA 23927-9125 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Teresa Parham | Nurse Practitioner | Cmh Physician Services, LLC | 61 Burlington Dr, Clarksville, VA 23927-3235 |
| Graham D Keats | Emergency Medicine | Cmh Physician Services, LLC | 61 Burlington Dr, Clarksville, VA 23927-3235 |
| Jenea Danielle Bennett-talley | Nurse Practitioner | Cmh Physician Services, LLC | 61 Burlington Dr, Clarksville, VA 23927-3235 |
| Kelly Mcdonald | Internal Medicine | Cmh Physician Services, LLC | 61 Burlington Dr, Clarksville, VA 23927-3235 |
| City | CLARKSVILLE |
| Zip Code | 23927 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | CLARKSVILLE + OBSTETRICS/GYNECOLOGY |
Please comment or provide details below to improve the information on Gwendolyn L Riddick.
| 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.