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General NPI Number Information
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NPI Number | 1669654729
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Entity Type | Organization
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Legal Business Name | CORPORATION LANE INTERNAL MEDICINE
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 12/04/2007
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Provider Practice Location Address
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Address Line | 4460 CORPORATION LN STE 190
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3150
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Country | US
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Telephone | 757-518-8823
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Fax | 757-518-8832
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Provider Business Mailing Address
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Address Line | 4460 CORPORATION LN STE 190
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3150
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Country | US
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Telephone | 757-518-8823
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Fax | 757-518-8832
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Authorized Official
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Title or Position | M.D
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Name | DR. HERBERT GEORGE KNIGHT
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Credential |
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Telephone | 757-518-8823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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