Healthcare Provider Details

I. General information

NPI: 1609819200
Provider Name (Legal Business Name): JAMES W RAWLES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 10/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 FIRST COLONIAL RD SUITE 300
VIRGINIA BEACH VA
23454-2409
US

IV. Provider business mailing address

1205 N BAY SHORE DR
VIRGINIA BEACH VA
23451-3714
US

V. Phone/Fax

Practice location:
  • Phone: 757-481-2127
  • Fax: 757-963-5585
Mailing address:
  • Phone: 757-428-0231
  • Fax: 757-963-5585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0101035515
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: