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General NPI Number Information
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NPI Number | 1952720690
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Entity Type | Individual
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Provider Name | PAMELA CRUZ REISER M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 701 S MAIN ST
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City | NORFOLK
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State | VA
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Zip | 23523-1245
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Country | US
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Telephone | 757-388-1830
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Fax | 855-939-7176
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Provider Business Mailing Address
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Address Line | 701 S MAIN ST
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City | NORFOLK
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State | VA
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Zip | 23523-1245
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Country | US
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Telephone | 757-388-1830
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Fax | 855-939-7176
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101262278
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License Number State | VA
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