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General NPI Number Information
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NPI Number | 1215117437
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Entity Type | Organization
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Legal Business Name | HAMPTON ROADS INTERNAL MEDICINE
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 12/28/2007
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Provider Practice Location Address
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Address Line | 2115 EXECUTIVE DR SUITE 2A
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City | HAMPTON
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State | VA
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Zip | 23666-2499
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Country | US
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Telephone | 757-827-1920
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Fax | 757-827-7509
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Provider Business Mailing Address
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Address Line | 2115 EXECUTIVE DRIVE SUITE 2A
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City | HAMPTON
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State | VA
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Zip | 23666-2411
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Country | US
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Telephone | 757-827-1920
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Fax | 757-827-7509
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HENRY LESTER ROTHFUSS
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Credential | M.D.
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Telephone | 757-827-1920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101033520
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License Number State | VA
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