Healthcare Provider Details

I. General information

NPI: 1780926741
Provider Name (Legal Business Name): JOSEPH A REZA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOSEPH ARTURO REZA MD

II. Dates (important events)

Enumeration Date: 03/17/2013
Last Update Date: 08/04/2023
Certification Date: 08/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6251 E VIRGINIA BEACH BLVD STE 300
NORFOLK VA
23502-2800
US

IV. Provider business mailing address

6251 E VIRGINIA BEACH BLVD STE 300
NORFOLK VA
23502-2800
US

V. Phone/Fax

Practice location:
  • Phone: 757-261-5000
  • Fax: 757-962-5610
Mailing address:
  • Phone: 757-261-5000
  • Fax: 757-962-5610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number0101277795
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: