Internal Medicine Kidney & Hypertension Center Pc | |
5700 Lake Wright Dr Ste 101 Norfolk VA 23502-1859 | |
(757) 502-4840 | |
(757) 502-4841 |
Full Name | Internal Medicine Kidney & Hypertension Center Pc |
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Speciality | Internal Medicine |
Location | 5700 Lake Wright Dr Ste 101, Norfolk, Virginia |
Authorized Official Name and Position | Humberto F. Pavon (PRESIDENT) |
Authorized Official Contact | 7575024840 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Internal Medicine Kidney & Hypertension Center Pc 5700 Lake Wright Dr Ste 101 Norfolk VA 23502-1859 Ph: (757) 502-4840 | Internal Medicine Kidney & Hypertension Center Pc 5700 Lake Wright Dr Ste 101 Norfolk VA 23502-1859 Ph: (757) 502-4840 |
NPI Number | 1497823728 |
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Provider Enumeration Date | 12/04/2006 |
Last Update Date | 06/18/2015 |
Medicare PECOS PAC ID | 7113029026 |
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Medicare Enrollment ID | O20070223000379 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497823728 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 0101024987 (Virginia) | Primary |
207RN0300X | Internal Medicine - Nephrology | 0101024987 (Virginia) | Secondary |
Provider Name | Humberto F Pavon |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1588661219 PECOS PAC ID: 6002918919 Enrollment ID: I20070223000432 |
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