NPI | 1053558981 |
---|---|
Doing Business As | TIDEWATER MEDICAL CARE PC |
Entity Type | Organization |
Authorized Contact | MIGDONIA MONTEJO Owner/President 757-965-9465 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101058505) |
Enumeration Date | 2009-01-14 |
Last Update Date | 2010-02-03 |