DR. MELVIN L PEGRAM M.D. NPI 1083773089

NPI Information

NPI: 1083773089
Provider Name: DR. MELVIN L PEGRAM, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Organization: SOUTHEASTERN INTENSIVIST SERVICES PC

PECOS Registration: Yes

Address:
5801 BREMO RD
RICHMOND, VA
ZIP 23226
Phone: (804) 287-7270
Get Directions

DR. Melvin L Pegram, M.D. is a family medicine in Richmond, VA with 27 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Melvin L Pegram, M.D. NPI is 1083773089. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5801 BREMO RD
RICHMOND, VA
ZIP 23226-907
Phone: (804) 287-7270
Fax: (804) 285-0726

The NPI 1083773089 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/6/2006 and was last updated on 12/19/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		0101223741	VIRGINIA	Yes
2	208M00000X	Hospitalist		0101223741	VIRGINIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1083773089	MEDICAID	VIRGINIA
2	1083773089	OTHER	VIRGINIA	NPI
3	P00685255	OTHER	VIRGINIA	RR MEDICARE
4	C06778	OTHER	VIRGINIA	GROUP PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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