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General NPI Number Information
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NPI Number | 1104917145
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Entity Type | Organization
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Legal Business Name | FAMILY & INTERNAL MEDICAL CNTR
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 04/09/2014
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Provider Practice Location Address
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Address Line | 2020 S INDEPENDENCE BLVD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23453-4776
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Country | US
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Telephone | 757-471-3100
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Fax | 757-471-3624
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Provider Business Mailing Address
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Address Line | 1708 MERCHANTS HOPE CT
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-7012
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JITENDRA PATEL
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Credential | M.D.
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Telephone | 757-471-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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