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General NPI Number Information
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NPI Number | 1326175043
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Entity Type | Organization
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Legal Business Name | HAMPTON ROADS FAMILY PRACTICE
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 665 NEWTOWN RD STE 114
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-1683
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Country | US
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Telephone | 757-490-1226
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Fax |
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Provider Business Mailing Address
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Address Line | 665 NEWTOWN RD STE 114
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-1683
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Country | US
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Telephone | 757-490-1226
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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. MOHAMMAD RASSOOL
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Credential | MD
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Telephone | 757-490-1226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 0103300868
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101038190
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License Number State | VA
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