| NPI | 1790880623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIPES K RAY M.D. 757-410-8745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA G66860) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA H82305) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2008-04-20 |