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General NPI Number Information
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NPI Number | 1568692879
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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 | 07/21/2009
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Last Update Date | 03/11/2019
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Provider Practice Location Address
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Address Line | 1080 FIRST COLONIAL RD STE 305
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-2406
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Country | US
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Telephone | 757-388-5680
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Fax | 757-388-5681
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Provider Business Mailing Address
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Address Line | 2859 VIRGINIA BEACH BLVD SUITE 101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-7613
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Country | US
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Telephone | 757-388-5680
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Fax | 757-388-5681
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. CINDY A TAYLOR
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Credential |
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Telephone | 757-252-2765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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