Healthcare Provider Details

I. General information

NPI: 1992802722
Provider Name (Legal Business Name): ELENA T VITERBO-NOBLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA ELENA T VITERBO MD

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 10/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7151 RICHMOND ROAD SUITE405
WILLIAMSBURG VA
23188
US

IV. Provider business mailing address

860 OMNI BLVD SUITE 303
NEWPORT NEWS VA
23606
US

V. Phone/Fax

Practice location:
  • Phone: 757-564-3700
  • Fax: 757-564-8515
Mailing address:
  • Phone: 757-232-8777
  • Fax: 757-232-8866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME96089
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: