MARY IMMACULATE HOSPITAL NPI 1689047979

NPI Information

  • NPI: 1689047979
  • Provider Name: MARY IMMACULATE HOSPITAL
  • Classification: Surgery - 2086S0129X
  • Specialization: Vascular Surgery
  • Entity Type: Organization
  • Doing Business As: DBA BON SECOURS VEIN AND VASCULAR SPECIALISTS @ MIH
  • Address: 12720 MCMANUS BLVD
    SUITE 203
    NEWPORT NEWS, VA
    ZIP 23602
  • Phone: (757) 397-2383

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NPI Details

MARY IMMACULATE HOSPITAL is a vascular surgery surgery in Newport News, VA. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. MARY IMMACULATE HOSPITAL NPI is 1689047979. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Dba Bon Secours Vein And Vascular Specialists @ Mih.

The provider's business location address is:

12720 MCMANUS BLVD
SUITE 203
NEWPORT NEWS, VA
ZIP 23602-414
Phone: (757) 397-2383
Fax: (757) 673-0236

The provider's authorized official is Karen A Smith .
The authorized official title is Credentialing Specialist and has the following contact phone number (757) 215-2784.

The enumeration date for this NPI number is 11/9/2015 and was last updated on 11/9/2015.

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
12086S0129XSurgeryVascular SurgeryYes

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 Other Provider Identifier Issuer
1C10716MEDICARE PINVIRGINIA

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: 3/30/2025

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