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General NPI Number Information
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NPI Number | 1972759496
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE MEDICAL CENTER LLC
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Dates
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Enumeration Date | 08/15/2008
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Last Update Date | 04/26/2015
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Provider Practice Location Address
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Address Line | 4876 BAXTER ROAD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462
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Country | US
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Telephone | 757-671-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 4876 BAXTER ROAD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462
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Country | US
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Telephone | 757-671-7777
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NASSER HAMBAZ
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Credential | MD
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Telephone | 757-671-7777
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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 | 0101037952
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License Number State | VA
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