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NPI Code Detail

MEDICARE: UROLOGY OF VIRGINIA, PC

MEDICARE: UROLOGY OF VIRGINIA, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology Physician

General Provider Information

NPI Number : 1417935636
Entity Type Code : Organization
Provider Name (Legal Business Name) : UROLOGY OF VIRGINIA, PC
Provider Business Mailing Address
First Line : PO BOX 791254
Second Line :
City : BALTIMORE
State : MD
Zip : 21279-1254
Country : US
Telephone Number : 757-466-0800
Fax Number : 757-466-1310
Provider Business Practice Location Address
First Line : 6333 CENTER DR
Second Line : BLDG. 16
City : NORFOLK
State : VA
Zip : 23502-4126
Country : US
Telephone Number : 757-466-0800
Fax Number : 757-466-1310
Authorized Official
Title or Position : MANAGING EMPLOYEE
Name : LORI S DELBRIDGE
Credential :
Telephone Number : 757-466-3410
Provider Enumeration Date : 01/06/2006
Last Update Date : 04/20/2008

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Directions to “UROLOGY OF VIRGINIA, PC ” Practice Location

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