DR. CHARLES A. BULLABOY M.D. NPI 1699724245

NPI Information

NPI: 1699724245
Provider Name: DR. CHARLES A. BULLABOY, M.D.
Classification: Pediatrics - 2080P0202X
Entity Type: Individual

Specialization: Pediatric Cardiology

Address:
601 CHILDRENS LN
NORFOLK, VA
ZIP 23507
Phone: (757) 668-7213
Get Directions

DR. Charles A. Bullaboy, M.D. is a pediatric cardiology pediatrics in Norfolk, VA. The provider is a pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. DR. Charles A. Bullaboy, M.D. NPI is 1699724245. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

601 CHILDRENS LN
NORFOLK, VA
ZIP 23507-910
Phone: (757) 668-7213
Fax: (757) 668-8225

The enumeration date for this NPI number is 5/10/2006 and was last updated on 11/29/2012.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		0101058010	VIRGINIA	No
2	2080P0202X	Pediatrics	Pediatric Cardiology	0101028010	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	B06494	MEDICARE UPIN
2	7905245	MEDICAID	NORTH CAROLINA
3	060000820	MEDICARE ID-TYPE UNSPECIFIED	VIRGINIA
4	0016948820001	MEDICAID	PENNSYLVANIA
5	0197625000	MEDICAID	WEST VIRGINIA
6	006722296	MEDICAID	VIRGINIA
7	119541700	MEDICAID	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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