Healthcare Provider Details

I. General information

NPI: 1447219241
Provider Name (Legal Business Name): EXPRESS MEDICAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1543 AMBERLEY FOREST ROAD
VIRGINIA BEACH VA
23453
US

IV. Provider business mailing address

1543 AMBERLEY FOREST ROAD
VIRGINIA BEACH VA
23453
US

V. Phone/Fax

Practice location:
  • Phone: 757-471-7700
  • Fax: 757-471-9541
Mailing address:
  • Phone: 757-471-7700
  • Fax: 757-471-9541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WAYNE MICHAEL MCDERMOTT
Title or Position: PRESIDENT
Credential: MD
Phone: 757-471-7700