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General NPI Number Information
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NPI Number | 1407031537
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Entity Type | Organization
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Legal Business Name | VIRGINIA BEACH UROLOGICAL ASSOCIATES LTD
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 03/16/2012
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Provider Practice Location Address
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Address Line | 1004 FIRST COLONIAL RD SUITE 101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454
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Country | US
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Telephone | 757-481-9402
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Fax | 757-481-0657
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Provider Business Mailing Address
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Address Line | 1004 FIRST COLONIAL RD SUITE 101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454
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Country | US
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Telephone | 757-481-9402
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Fax | 757-481-0657
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEVEN S WARDEN
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Credential | MD FACS MBA
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Telephone | 757-481-9402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 0101031498
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License Number State | VA
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