Healthcare Provider Details

I. General information

NPI: 1740546134
Provider Name (Legal Business Name): PARTNERS IN PEDIATRIC CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 04/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 LOUISA AVE STE 118
VIRGINIA BEACH VA
23454-4669
US

IV. Provider business mailing address

324 LOUISA AVE STE 118
VIRGINIA BEACH VA
23454-4669
US

V. Phone/Fax

Practice location:
  • Phone: 757-333-7797
  • Fax: 757-961-9767
Mailing address:
  • Phone: 757-333-7797
  • Fax: 757-961-9767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: LORI S DELBRIDGE
Title or Position: CONSULTANT
Credential: MBA
Phone: 757-403-1442