Family Physicians Of Tidewater Pllc

NPI 1790830826 - Family Medicine - 207Q00000X

NPI Details
NPI 1790830826
Enumeration Date 01/25/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name CLEMENT STOKES CLEMENT
Position PRESIDENT
Phone (757) 889-6520
Fax (757) 489-4905
Practice Location
110 KINGSLEY LN
SUITE 202
NORFOLK VA, 23505-4614, US
Phone (757) 889-6520
Fax (757) 489-4905
Business Location
110 KINGSLEY LN
SUITE 202
NORFOLK VA, 23505-4614, US
Phone (757) 889-6520
Fax (757) 489-4905
Toxanomy
Taxonomy Code 207Q00000X
License State
License Number
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According to our database, Family Physicians Of Tidewater Pllc NPI is 1790830826, taxonomy code is 207Q00000X Family Physicians Of Tidewater Pllc physically located at 110 Kingsley Ln, Norfolk VA, 23505-4614. NPI Number 1033115704 has the healthcare provider type.

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1790830826 NPI number is provided on an as is basis without warranty of any kind. 1790830826 is maintained by the National Plan & Provider Enumeration System. The contents of Family Physicians Of Tidewater Pllc are for informational purposes only.