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General NPI Number Information
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NPI Number | 1902109895
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Entity Type | Organization
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Legal Business Name | BAYVIEW PHYSICIAN SERVICES, PC
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Dates
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Enumeration Date | 12/15/2010
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 1168 FIRST COLONIAL RD STE 301
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-2444
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Country | US
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Telephone | 757-481-0898
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Fax | 757-481-2563
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Provider Business Mailing Address
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Address Line | PO BOX 7068
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City | PORTSMOUTH
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State | VA
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Zip | 23707-0068
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Country | US
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Telephone | 757-686-3508
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Fax | 757-686-0541
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Authorized Official
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Title or Position | DIRECTOR
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Name | JEFFREY DAVID FORMAN
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Credential |
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Telephone | 757-923-9604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0103000798
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License Number State | VA
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