| NPI | 1225246812 |
|---|---|
| Former Legal Business Name | GASTROINTESTINAL AND LIVER SPECIALISTS OF TIDEWATER, PLLC |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY M SHORT CEO 757-803-6483 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2025-08-26 |