is a Pediatric Emergency Medicine in Virginia Beach, Virginia. practices all healthcare services and medical treatments related to Pediatric Emergency Medicine. The NPI Number for is 1548212079. The last update date is .
's current location address is 2021 Concert Dr Ste 102, Virginia Beach, Virginia. You can contact this provider via phone number 7576684933 and fax number 7576684947. The mailing address for is 2021 Concert Dr Ste 102, Virginia Beach, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 2021 Concert Dr Ste 102, Virginia Beach, Virginia |
| Phone Number | 7576684933 |
| Fax Number | 7576684947 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1548212079 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 2021 Concert Dr Ste 102 |
|---|---|
| City | Virginia Beach |
| State | Virginia (VA) |
| Post Code | 234568082 |
| Phone Number | 7576684933 |
| Fax Number | 7576684947 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Emergency Medicine |
|---|---|
| Taxonomy | 2080P0204X |
| Licence No | 101052583 |
|
Definition: A pediatrician who has special qualifications to manage emergencies in infants and children. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 16510250001 | PA | -- | |
| 6721893 | VA | -- | |
| 2002462000 | WV | -- | |
| 220531900 | MD | -- | |
| 7905361 | NC | -- | |
| 1000015893 | DE | -- |
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