Chesapeake Bay Ent Pc

NPI 1013106541 - Specialist - 174400000X

NPI Details
NPI 1013106541
Enumeration Date 10/22/2007
Last Updated 01/28/2014
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name DETRA RENEE DETRA
Position REGIONAL PRACTICE ADMINISTRATOR
Phone (757) 442-7040
Fax (757) 442-7080
Practice Location
36080 LANKFORD HWY
BELLE HAVEN VA, 23306-0000, US
Phone (757) 442-7040
Fax (757) 442-7080
Business Location
1270 DIAMOND SPRINGS RD
SUITE 118, #712
VIRGINIA BEACH VA, 23455-3729, US
Phone (757) 442-7040
Fax (757) 442-7080
Toxanomy
Taxonomy Code 174400000X
License State
License Number
Remove 1013106541 NPI Number
 

According to our database, Chesapeake Bay Ent Pc NPI is 1013106541, taxonomy code is 174400000X Chesapeake Bay Ent Pc physically located at 36080 Lankford Hwy, Belle Haven VA, 23306-0000. NPI Number 1033115704 has the healthcare provider type.

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1013106541 NPI number is provided on an as is basis without warranty of any kind. 1013106541 is maintained by the National Plan & Provider Enumeration System. The contents of Chesapeake Bay Ent Pc are for informational purposes only.