| |
2115 Executive Dr Suite 3a Hampton VA 23666-2499 | |
(757) 262-0002 | |
(757) 262-0007 |
Full Name | |
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Speciality | Family Medicine |
Location | 2115 Executive Dr, Hampton, Virginia |
Authorized Official Name and Position | Edward Wayne Haga (PRESIDENT) |
Authorized Official Contact | 7578809047 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2115 Executive Dr Suite 3a Hampton VA 23666-2499 Ph: (757) 262-0002 | 2115 Executive Dr Suite 3a Hampton VA 23666-2499 Ph: (757) 262-0002 |
NPI Number | 1386916278 |
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Provider Enumeration Date | 02/07/2012 |
Last Update Date | 02/07/2012 |
Identifier | Type | State | Issuer |
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1386916278 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 0101043992 (Virginia) | Primary |
Mbs Child Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 240 S Second St, Hampton, VA 23664 Phone: 767-902-6108 | |
Gastroenterology Specialist Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Marcella Rd, Suite A, Hampton, VA 23666 Phone: 757-826-6539 | |
Southampton Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2112 Executive Dr, Hampton, VA 23666 Phone: 757-723-0252 Fax: 866-837-2972 | |