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TIDEWATER PED. CONSULTANTS PC NPI 1841298759


NPI Information

NPI: 1841298759
Provider Name: TIDEWATER PED. CONSULTANTS, PC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 49D2078389

Address:
6477 COLLEGE PARK SQ
STE 118
VIRGINIA BEACH, VA
ZIP 23464
Phone: (757) 420-6218
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TIDEWATER PED. CONSULTANTS, PC is a pediatrics in Virginia Beach, VA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. TIDEWATER PED. CONSULTANTS, PC NPI is 1841298759. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6477 COLLEGE PARK SQ
STE 118
VIRGINIA BEACH, VA
ZIP 23464-611
Phone: (757) 420-6218
Fax: (757) 420-0487

The provider's authorized official is Rosetta S Cherry .
The authorized official title is Practice Manager and has the following contact phone number (757) 420-0487.

The CLIA number assigned to this NPI record is 49D2078389 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/13/2005 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics002500-8011VIRGINIAYes

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

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