| NPI | 1225557556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA MILLER Practice Administrator 757-917-5246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 207Q00000X Family Medicine | |
| 207QA0505X Family Medicine Adult Medicine | |
| 207QG0300X Family Medicine Geriatric Medicine | |
| 207R00000X Internal Medicine | |
| 207RI0200X Internal Medicine Infectious Disease | |
| 363A00000X Physician Assistant | |
| 363LA2200X Nurse Practitioner Adult Health | |
| 363LF0000X Nurse Practitioner Family | |
| 363LG0600X Nurse Practitioner Gerontology | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2020-03-18 |