| NPI | 1053678839 |
|---|---|
| Doing Business As | TIDEWATER VASCULAR ACCESS CENTER |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH F SKIDMORE Practice Administrator 757-623-0005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology |
| 2086S0129X Surgery, Vascular Surgery | |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2022-01-20 |