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NPI Code Detail

MEDICARE: DR. CAROL ANNE PURDY D.O.

MEDICARE: DR. CAROL ANNE PURDY D.O.
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
1207QA0401XAddiction Medicine (Family Medicine) Physician0102049937VA
2207Q00000XFamily Medicine Physician0102049937VA

General Provider Information

NPI Number : 1598715211
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROL ANNE PURDY D.O.
Provider Business Mailing Address
First Line : 12997 WARWICK BLVD
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23602-8352
Country : US
Telephone Number : 757-369-3357
Fax Number :
Provider Business Practice Location Address
First Line : 12997 WARWICK BLVD
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23602-8352
Country : US
Telephone Number : 757-369-3357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 07/25/2022

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