Tidewater Physicians Multispecialty Group

NPI 1275884546 - Clinical Medical Laboratory - 291U00000X

NPI Details
NPI 1275884546
Enumeration Date 09/27/2012
Last Updated 09/27/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name ANNETTE ANNETTE
Position CBO MANAGER
Phone (757) 873-0952
Fax (757) 327-0686
Practice Location
860 OMNI BLVD
SUITE 206
NEWPORT NEWS VA, 23606-4430, US
Phone (757) 873-0952
Fax (757) 327-0686
Business Location
860 OMNI BLVD
SUITE 303
NEWPORT NEWS VA, 23606-4430, US
Phone (757) 232-8769
Fax (757) 232-8875
Toxanomy
Taxonomy Code 291U00000X
License State Virginia
License Number 206519
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According to our database, Tidewater Physicians Multispecialty Group NPI is 1275884546, taxonomy code is 291U00000X and license number is 206519, license state is located at Virginia. Tidewater Physicians Multispecialty Group physically located at 860 Omni Blvd, Newport News VA, 23606-4430. NPI Number 1033115704 has the healthcare provider type.

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1275884546 NPI number is provided on an as is basis without warranty of any kind. 1275884546 is maintained by the National Plan & Provider Enumeration System. The contents of Tidewater Physicians Multispecialty Group are for informational purposes only.