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General NPI Number Information
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NPI Number | 1568627834
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Entity Type | Organization
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Legal Business Name | PULMONARY MEDICINE OF VIRGINIA BEACH, INC.
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Dates
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Enumeration Date | 07/25/2008
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Last Update Date | 03/06/2009
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Provider Practice Location Address
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Address Line | 1008 FIRST COLONIAL RD SUITE 103
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3071
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Country | US
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Telephone | 757-481-2515
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Fax | 757-481-4064
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Provider Business Mailing Address
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Address Line | 1008 FIRST COLONIAL RD SUITE 103
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3071
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Country | US
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Telephone | 757-481-2515
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Fax | 757-481-4064
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. ELIZABETH RENE POPLAWSKY
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Credential |
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Telephone | 757-481-2515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State | VA
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