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400 Gresham Dr Suite 808 Norfolk VA 23507-1901 | |
| (757) 622-7998 | |
| (757) 215-2729 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 400 Gresham Dr, Norfolk, Virginia |
| Authorized Official Name and Position | Michael Kerner (CHEIF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7576735920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
400 Gresham Dr Suite 808 Norfolk VA 23507-1901 Ph: (757) 622-7998 | 400 Gresham Dr Suite 808 Norfolk VA 23507-1901 Ph: (757) 622-7998 |
| NPI Number | 1740618412 |
|---|---|
| Provider Enumeration Date | 10/16/2013 |
| Last Update Date | 10/16/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740618412 | NPI | - | NPPES |
| C06209 | Other | VA | GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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