NPI | 1659563799 |
---|---|
Former Legal Business Name | GASTROINTESTINAL AND LIVER SPECIALISTS OF TIDEWATER, PLLC |
Entity Type | Organization |
Authorized Contact | TIMOTHY SHORT CEO 757-803-6483 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
Enumeration Date | 2007-08-13 |
Last Update Date | 2025-08-26 |