Healthcare Provider Details

I. General information

NPI: 1164656401
Provider Name (Legal Business Name): SOLMAZ AMIRNAZMI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2009
Last Update Date: 10/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12715 WARWICK BLVD SUITE O
NEWPORT NEWS VA
23606-1800
US

IV. Provider business mailing address

856 J CLYDE MORRIS BLVD SUITE A
NEWPORT NEWS VA
23601-1318
US

V. Phone/Fax

Practice location:
  • Phone: 757-930-0091
  • Fax: 757-269-4406
Mailing address:
  • Phone: 757-594-4006
  • Fax: 757-534-5190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101251690
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: