MEDICARE: DAVID ANDERSON VINCENT M.D.

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
1	207T00000X	Neurological Surgery Physician	0101234918	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00143405	OTHER	VA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	71052	OTHER		SENTARA HEALTH PLAN
3	102643	OTHER	VA	ANTHEM BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	149158900	OTHER		US DEPT OF LABOR

General Provider Information

NPI Number	:	1477552552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ANDERSON VINCENT M.D.

Provider Business Mailing Address
First Line	:	5716 CLEVELAND ST STE 200
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-1784
Country	:	US
Telephone Number	:	575-028-5837
Fax Number	:	757-226-9044

Provider Business Practice Location Address
First Line	:	5716 CLEVELAND ST STE 200
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462
Country	:	US
Telephone Number	:	757-502-8583
Fax Number	:	757-226-9044

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	04/18/2023

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