Colon Rectal Surgery Of Tidewater, P.C. in Portsmouth - Colon & Rectal Surgery
Colon Rectal Surgery Of Tidewater, P.C. - NPI 1790794022
Colon Rectal Surgery Of Tidewater, P.C. is a Colon & Rectal Surgery in Portsmouth, Virginia. Colon Rectal Surgery Of Tidewater, P.C. practices all healthcare services and medical treatments related to Colon & Rectal Surgery. The NPI Number for Colon Rectal Surgery Of Tidewater, P.C. is 1790794022. The last update date is 2011-09-14.
Colon Rectal Surgery Of Tidewater, P.C.'s current location address is 3235 Academy Ave, Portsmouth, Virginia. You can contact this provider via phone number 7574849653 and fax number 7574849662. The mailing address for Colon Rectal Surgery Of Tidewater, P.C. is 3235 Academy Ave, Portsmouth, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Colon Rectal Surgery Of Tidewater, P.C. |
|---|---|
| Address | 3235 Academy Ave, Portsmouth, Virginia |
| Phone Number | 7574849653 |
| Fax Number | 7574849662 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Wolf Stephen Jeffrey |
| Credentials | M.D. |
| Telephone Number | 7574849653 |
NPI Number Detail
| NPI Number | 1790794022 |
|---|---|
| Provider Enumeration Date | 2006-08-05 |
| Last Updated Date | 2011-09-14 |
Provider Mailing Address Detail
| Address | 3235 Academy Ave |
|---|---|
| City | Portsmouth |
| State | Virginia (VA) |
| Post Code | 237033200 |
| Phone Number | 7574849653 |
| Fax Number | 7574849662 |
Provider's Primary Taxonomy Detail
| Speciality | Colon & Rectal Surgery |
|---|---|
| Taxonomy | 208C00000X |
| Licence No | 101031444 |
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Definition: A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liv |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5841232 | VA | -- | |
| 72337 | VA | BC/BS | |
| 200136 | VA | OPTIMA | |
| 292832 | VA | MAMSI | |
| 890528E | NC | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Colon Rectal Surgery Of Tidewater, P.C. by the Centers for Medicare & Medicaid Services?
The Colon Rectal Surgery Of Tidewater, P.C. has been assigned the NPI (National Provider Identifier) 1790794022. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Colon Rectal Surgery Of Tidewater, P.C. is physically located?
The Colon Rectal Surgery Of Tidewater, P.C. is physically situated at the following address: 3235 Academy Ave, Portsmouth, VA, 237033200.
What is the Colon Rectal Surgery Of Tidewater, P.C.'s specialty and taxonomy code?
The Colon Rectal Surgery Of Tidewater, P.C.'s specialty is Colon & Rectal Surgery, and the corresponding taxonomy code is 208C00000X.
When did the Colon Rectal Surgery Of Tidewater, P.C. receive its 1790794022?
The Colon Rectal Surgery Of Tidewater, P.C. was issued its 1790794022 on 2006-08-05, which is the date when the organization was assigned this unique identifier.
When was the Colon Rectal Surgery Of Tidewater, P.C.'s information last updated?
The Colon Rectal Surgery Of Tidewater, P.C.'s information was last updated on 2011-09-14.