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General NPI Number Information
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NPI Number | 1871588145
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Entity Type | Individual
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Provider Name | JUNI A. FEMI-PEARSE M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 01/28/2011
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Provider Practice Location Address
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Address Line | 5484 MEMORIAL DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-3782
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Country | US
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Telephone | 505-702-5404
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Fax | 757-228-7323
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Provider Business Mailing Address
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Address Line | 5484 MEMORIAL DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-3792
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Country | US
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Telephone | 505-702-5404
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Fax | 757-228-7323
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35066
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101221384
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License Number State | VA
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