| Southside Psychiatry Clinic | |
|
317 Office Square Ln Ste B102 Virginia Beach VA 23462 | |
| (757) 469-6003 | |
| Not Available |
| Full Name | Southside Psychiatry Clinic |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 317 Office Square Ln Ste B102, Virginia Beach, Virginia |
| Authorized Official Name and Position | Yongbing L Pu (PRESIDENT) |
| Authorized Official Contact | 7574696003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Psychiatry Clinic 317 Office Square Ln Ste B102 Virginia Beach VA 23462-3650 Ph: (757) 469-6003 | Southside Psychiatry Clinic 317 Office Square Ln Ste B102 Virginia Beach VA 23462 Ph: (757) 469-6003 |
| NPI Number | 1528515996 |
|---|---|
| Provider Enumeration Date | 09/02/2016 |
| Last Update Date | 09/03/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528515996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 0101253996 (Virginia) | Primary |
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