Healthcare Provider Details

I. General information

NPI: 1437113487
Provider Name (Legal Business Name): VALERIO MARIA GENTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 FIRST COLONIAL ROAD SENTARA VIRGINIA BEACH GENERAL HOSPITAL
VIRGINIA BEACH VA
23454-3002
US

IV. Provider business mailing address

2876 GUARDIAN LN
VIRGINIA BEACH VA
23452-7327
US

V. Phone/Fax

Practice location:
  • Phone: 757-395-8000
  • Fax: 757-395-8653
Mailing address:
  • Phone: 757-463-5240
  • Fax: 757-463-6572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZM0300X
TaxonomyMedical Microbiology Physician
License Number0101033451
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number0101033451
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: