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General NPI Number Information
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NPI Number | 1558018481
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Entity Type | Organization
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Legal Business Name | SENTARA MEDICAL GROUP
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Dates
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Enumeration Date | 03/10/2022
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 6251 E VIRGINIA BEACH BLVD STE 401
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City | NORFOLK
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State | VA
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Zip | 23502-2824
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Country | US
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Telephone | 757-624-0240
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Fax | 757-756-5154
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Provider Business Mailing Address
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Address Line | 6251 E VIRGINIA BEACH BLVD STE 401
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City | NORFOLK
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State | VA
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Zip | 23502-2824
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Country | US
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Telephone | 757-624-0240
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Fax | 757-756-5154
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Authorized Official
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Title or Position | DIRECTOR
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Name | DORIS PRINCE
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Credential |
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Telephone | 757-983-5475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163WM1400X
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Taxonomy Name | Nurse Massage Therapist (NMT)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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