| NPI | 1902848294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA WALKER Credentialing Coordinator 757-232-8769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 182340975) | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RN0300X Internal Medicine, Nephrology (Licence: VA 223741512) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: VA 229641543) | |
| 207V00000X Obstetrics & Gynecology | |
| 207W00000X Ophthalmology | |
| 207X00000X Orthopaedic Surgery | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 208600000X Surgery | |
| 208800000X Urology | |
| 213ES0131X Podiatrist, Foot Surgery (Licence: VA 0103300835) | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2023-12-15 |