MEDICARE: DR. THOMAS JOSEPH BERENGUER 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	207V00000X	Obstetrics & Gynecology Physician	0101019804	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871791533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS JOSEPH BERENGUER M.D.

Provider Business Mailing Address
First Line	:	5589 GREENWICH RD
Second Line	:	SUITE 100
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6565
Country	:	US
Telephone Number	:	757-557-0200
Fax Number	:	757-557-6886

Provider Business Practice Location Address
First Line	:	5589 GREENWICH RD
Second Line	:	SUITE 100
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6565
Country	:	US
Telephone Number	:	757-557-0200
Fax Number	:	757-557-6886

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

Provider Enumeration Date	:	07/04/2007
Last Update Date	:	07/08/2007

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