| Pediatric Consultants Of Hampton Roads | |
|
1405 Kiln Creek Pkwy Ste E Newport News VA 23602-9700 | |
| (757) 875-9700 | |
| (757) 875-1028 |
| Full Name | Pediatric Consultants Of Hampton Roads |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1405 Kiln Creek Pkwy, Newport News, Virginia |
| Authorized Official Name and Position | Tien L Vanden Hoek (PARTNER) |
| Authorized Official Contact | 7578759700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Consultants Of Hampton Roads 1405 Kiln Creek Pkwy Ste E Newport News VA 23602-9700 Ph: (757) 875-9700 | Pediatric Consultants Of Hampton Roads 1405 Kiln Creek Pkwy Ste E Newport News VA 23602-9700 Ph: (757) 875-9700 |
| NPI Number | 1235222571 |
|---|---|
| Provider Enumeration Date | 10/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235222571 | NPI | - | NPPES |
| 6700047 | Medicaid | VA | |
| 6700136 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0101046667 (Virginia) | Primary |
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