Healthcare Provider Details

I. General information

NPI: 1932206125
Provider Name (Legal Business Name): CHESAPEAKE HOSPITALISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 11/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 N. BATTLEFIELD BLVD
CHESAPEAKE VA
23320-4941
US

IV. Provider business mailing address

P.O. BOX 16180
CHESAPEAKE VA
23328-6180
US

V. Phone/Fax

Practice location:
  • Phone: 757-312-6585
  • Fax:
Mailing address:
  • Phone: 757-312-6585
  • Fax: 757-222-1708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101056073
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID R. FULP
Title or Position: PRESIDENT
Credential: M.D.
Phone: 757-312-6585