TIDEWATER MEDICAL CARE PC NPI 1053558981

NPI Information

TIDEWATER MEDICAL CARE PC is a family medicine in Virginia Beach, VA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. TIDEWATER MEDICAL CARE PC NPI is 1053558981. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Tidewater Medical Care Pc.

The provider's business location address is:

4608 THOROUGHGOOD DRIVE
VIRGINIA BEACH, VA
ZIP 23455
Phone: (757) 965-9465
Fax: (757) 965-9491

The provider's authorized official is Migdonia Montejo .
The authorized official title is Owner/president and has the following contact phone number (757) 965-9465.

The CLIA number assigned to this NPI record is 49D0228956 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 1/14/2009 and was last updated on 2/3/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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