Healthcare Provider Details

I. General information

NPI: 1124200258
Provider Name (Legal Business Name): M.T. CURRY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 BAYLOR CT
CHESAPEAKE VA
23320-3824
US

IV. Provider business mailing address

733 VOLVO PKWY SUITE 200
CHESAPEAKE VA
23320-1609
US

V. Phone/Fax

Practice location:
  • Phone: 757-547-5851
  • Fax: 888-371-4920
Mailing address:
  • Phone: 757-547-5851
  • Fax: 888-371-4920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number0101047699
License Number StateVA

VIII. Authorized Official

Name: ERIC CURRY
Title or Position: V.P. OPERATIONS
Credential:
Phone: 757-410-4008