| Tidewater Physicians Multispecialty Group Pc | |
|
860 Omni Blvd Ste 401 Newport News VA 23606-4430 | |
| (757) 232-8764 | |
| Not Available |
| Full Name | Tidewater Physicians Multispecialty Group Pc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 860 Omni Blvd Ste 401, Newport News, Virginia |
| Authorized Official Name and Position | Angela Walker (CREDENTIALING MANAGER) |
| Authorized Official Contact | 7572328769 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidewater Physicians Multispecialty Group Pc 11761 Rock Landing Dr Ste 8 Newport News VA 23606-4235 Ph: (757) 232-8769 | Tidewater Physicians Multispecialty Group Pc 860 Omni Blvd Ste 401 Newport News VA 23606-4430 Ph: (757) 232-8764 |
| NPI Number | 1326428129 |
|---|---|
| Provider Enumeration Date | 06/05/2015 |
| Last Update Date | 11/09/2021 |
| Certification Date | 11/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326428129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0701001988 (Virginia) | Primary |
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