| NPI | 1891717625 |
|---|---|
| Doing Business As | RIVERSIDE TIDEWATER THORACIC & CARDIOVASCULAR |
| Entity Type | Organization |
| Authorized Contact | JAMES LESNICK Vice President 757-594-4006 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2011-10-12 |