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General NPI Number Information
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NPI Number | 1881210805
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Entity Type | Organization
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Legal Business Name | VIRGINIA GASTROENTEROLOGY INSTITUTE PC
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Dates
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Enumeration Date | 06/25/2020
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Last Update Date | 06/25/2020
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Provider Practice Location Address
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Address Line | 3910 BRIDGE RD STE 101
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City | SUFFOLK
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State | VA
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Zip | 23435-1107
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Country | US
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Telephone | 757-942-2566
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Fax | 855-313-1070
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Provider Business Mailing Address
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Address Line | 3910 BRIDGE RD STE 101
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City | SUFFOLK
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State | VA
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Zip | 23435-1107
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Country | US
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Telephone | 757-942-2566
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Fax | 855-313-1070
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Authorized Official
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Title or Position | BILLING
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Name | LISA WHITE
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Credential |
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Telephone | 757-942-2566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number |
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License Number State |
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