=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649356940
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARNOLD R OPPENHEIM M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/29/2006
-----------------------------------------------------
Last Update Date | 06/11/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5320 PROVIDENCE RD STE 202
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23464-4122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-523-4800
-----------------------------------------------------
Fax | 757-523-5857
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3729 REDWOOD FARM DR
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23452-4640
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-498-1356
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207N00000X
-----------------------------------------------------
Taxonomy Name | Dermatology Physician
-----------------------------------------------------
License Number | D0087639
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 0101033623
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------