| Executive Health Care Pc | |
|
4867 Baxter Rd Suite 105 Virginia Beach VA 23462-4469 | |
| (757) 473-9300 | |
| (757) 473-9361 |
| Full Name | Executive Health Care Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 4867 Baxter Rd, Virginia Beach, Virginia |
| Authorized Official Name and Position | Kamal Selim Louka (PRESIDENT) |
| Authorized Official Contact | 7574739300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Health Care Pc 4867 Baxter Rd Suite 105 Virginia Beach VA 23462-4469 Ph: (757) 473-9300 | Executive Health Care Pc 4867 Baxter Rd Suite 105 Virginia Beach VA 23462-4469 Ph: (757) 473-9300 |
| NPI Number | 1467662197 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 02/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467662197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101036392 (Virginia) | Primary |
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