| NPI | 1992752521 |
|---|---|
| Former Legal Business Name | GASTROINTESTINAL & LIVER SPECIALIST 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 | 2006-05-28 |
| Last Update Date | 2025-08-26 |