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General NPI Number Information
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NPI Number | 1871775734
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Entity Type | Organization
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Legal Business Name | SPECIALIST IN INFECTIOUS DISEASES, LLC
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 1404 GUNSTON CT
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City | CHESAPEAKE
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State | VA
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Zip | 23322-8100
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Country | US
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Telephone | 757-650-2725
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Fax |
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Provider Business Mailing Address
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Address Line | 1404 GUNSTON CT
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City | CHESAPEAKE
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State | VA
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Zip | 23322-8100
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Country | US
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Telephone | 757-650-2725
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Fax | 812-944-5403
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Authorized Official
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Title or Position | OWNER
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Name | MANALI PATEL
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Credential | MD
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Telephone | 502-558-4687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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