| Independence Family Medicine | |
|
813 Independence Blvd Suite A Virginia Beach VA 23455-6004 | |
| (757) 333-7625 | |
| (757) 333-7639 |
| Full Name | Independence Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 813 Independence Blvd, Virginia Beach, Virginia |
| Authorized Official Name and Position | Michael Vincent Moro (PRESIDENT) |
| Authorized Official Contact | 7573337625 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence Family Medicine 813 Independence Blvd Suite A Virginia Beach VA 23455-6004 Ph: (757) 333-7625 | Independence Family Medicine 813 Independence Blvd Suite A Virginia Beach VA 23455-6004 Ph: (757) 333-7625 |
| NPI Number | 1770678450 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 12/31/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770678450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101024391 (Virginia) | Primary |
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