Healthcare Provider Details
I. General information
NPI: 1558937086
Provider Name (Legal Business Name): TORRY MIQUEL PLEDGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/03/2021
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
191 FOX HILL RD
HAMPTON VA
23669-2360
US
IV. Provider business mailing address
856 J CLYDE MORRIS BLVD STE A
NEWPORT NEWS VA
23601-1318
US
V. Phone/Fax
- Phone: 757-850-1311
- Fax:
- Phone: 757-316-5800
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 0101282891 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: