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General NPI Number Information
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NPI Number | 1770169401
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Entity Type | Organization
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Legal Business Name | PHAIK MAE OBERMEYER MD PLLC
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Dates
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Enumeration Date | 03/23/2021
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Last Update Date | 03/23/2021
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Provider Practice Location Address
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Address Line | 840 FIRST COLONIAL RD STE 101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-6106
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Country | US
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Telephone | 757-321-6142
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Fax | 757-321-6145
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Provider Business Mailing Address
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Address Line | 840 FIRST COLONIAL RD STE 101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-6106
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Country | US
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Telephone | 757-321-6142
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Fax | 757-321-6145
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Authorized Official
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Title or Position | PHYSICIAN / OWNER
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Name | PHAIK MAE OBERMEYER
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Credential | MD
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Telephone | 757-375-6350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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