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NPI Code Detail

MEDICARE: DAREN MURRAY WINGARD M.D.

MEDICARE: DAREN MURRAY WINGARD M.D.
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
12081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician0101054459VA
2208100000XPhysical Medicine & Rehabilitation Physician0101054459VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124027305
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAREN MURRAY WINGARD M.D.
Provider Business Mailing Address
First Line : PO BOX 2546
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23450-2546
Country : US
Telephone Number : 757-340-3489
Fax Number : 757-340-4278
Provider Business Practice Location Address
First Line : 1147 INDEPENDENCE BLVD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23455-5545
Country : US
Telephone Number : 757-460-1207
Fax Number : 757-460-2136
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 03/07/2023

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