| NPI | 1083222129 |
|---|---|
| Doing Business As | TIDEWATER INFECTIOUS DISEASE PHYSICIANS |
| Entity Type | Organization |
| Authorized Contact | AMIR HAJIMOMENIAN Sole Member 757-354-2885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207R00000X Internal Medicine | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2020-09-21 |