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General NPI Number Information
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NPI Number | 1992951339
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Entity Type | Organization
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Legal Business Name | SENTARA MEDICAL GROUP
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 10/18/2011
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Provider Practice Location Address
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Address Line | 600 GRESHAM DR SUITE 8630
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City | NORFOLK
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State | VA
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Zip | 23507-1904
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Country | US
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Telephone | 757-388-6115
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Fax | 757-388-6116
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Provider Business Mailing Address
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Address Line | 600 GRESHAM DR SUITE 8630
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City | NORFOLK
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State | VA
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Zip | 23507-1904
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Country | US
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Telephone | 757-388-6115
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Fax | 757-388-6116
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. CINDY A TAYLOR
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Credential |
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Telephone | 757-252-3344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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