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General NPI Number Information
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NPI Number | 1275802415
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Entity Type | Organization
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Legal Business Name | DR THOMAS M SUVADA PC
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Dates
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Enumeration Date | 12/16/2011
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Last Update Date | 12/16/2011
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Provider Practice Location Address
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Address Line | 5505 INDIAN RIVER RD SUITE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-5252
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Country | US
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Telephone | 757-420-5505
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Fax | 757-420-3422
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Provider Business Mailing Address
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Address Line | 5505 INDIAN RIVER RD SUITE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-5252
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Country | US
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Telephone | 757-420-5505
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS SUVADA
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Credential | DC
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Telephone | 757-420-5505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104000690
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License Number State | VA
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