MEDICARE: DR. FELIX MOSES KIRVEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	0101054245	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	179191	OTHER	VA	BLUE CROSS BLUESHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093773764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FELIX MOSES KIRVEN

Provider Business Mailing Address
First Line	:	5701 CLEVELAND STREET
Second Line	:	SUITE 600
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462
Country	:	US
Telephone Number	:	757-963-6507
Fax Number	:	757-963-6375

Provider Business Practice Location Address
First Line	:	5701 CLEVELAND STREET
Second Line	:	SUITE 600
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462
Country	:	US
Telephone Number	:	757-963-6507
Fax Number	:	757-963-6375

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	10/07/2015

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