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General NPI Number Information
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NPI Number | 1730133398
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Entity Type | Organization
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Legal Business Name | FAMILY MEDICINE HEALTHCARE PLLC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 05/08/2021
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Provider Practice Location Address
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Address Line | 3925 PORTSMOUTH BLVD
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City | CHESAPEAKE
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State | VA
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Zip | 23321-3624
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Country | US
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Telephone | 757-488-3333
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Fax | 757-488-0007
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Provider Business Mailing Address
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Address Line | 3925 PORTSMOUTH BLVD
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City | CHESAPEAKE
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State | VA
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Zip | 23321-3624
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Country | US
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Telephone | 757-488-3333
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Fax | 757-488-0007
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Authorized Official
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Title or Position | OWNER/ PHYSICIAN
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Name | SAMIR TAWFIK ABDELSHAHEED
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Credential | M.D.
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Telephone | 757-488-3333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 0101028352
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101235873
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License Number State | VA
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