Healthcare Provider Details

I. General information

NPI: 1881641496
Provider Name (Legal Business Name): VICTOR T ANGLIN JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 BATTLEFIELD BLVD N
CHESAPEAKE VA
23320-4901
US

IV. Provider business mailing address

P.O. BOX 16180
CHESAPEAKE VA
23320-6180
US

V. Phone/Fax

Practice location:
  • Phone: 757-547-0688
  • Fax:
Mailing address:
  • Phone: 757-488-0985
  • Fax: 757-488-2544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101034865
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101034865
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: