MEDICARE: THE NEW HOPE CENTER FOR REPRODUCTIVE MEDICINE

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	207VE0102X	Reproductive Endocrinology Physician

General Provider Information

NPI Number	:	1326622747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE NEW HOPE CENTER FOR REPRODUCTIVE MEDICINE

Provider Business Mailing Address
First Line	:	448 VIKING DR STE 100
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-7331
Country	:	US
Telephone Number	:	757-496-5370
Fax Number	:	757-481-3354

Provider Business Practice Location Address
First Line	:	448 VIKING DR STE 100
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-7331
Country	:	US
Telephone Number	:	757-496-5370
Fax Number	:	757-481-3354

Authorized Official
Title or Position	:	CONSULTANT
Name	:	LINDA DIANE FREDERICK
Credential	:
Telephone Number	:	757-581-0506

Provider Enumeration Date	:	05/11/2021
Last Update Date	:	05/11/2021

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