MEDICARE: SENTARA MEDICAL GROUP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1649397233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENTARA MEDICAL GROUP

Provider Business Mailing Address
First Line	:	984B LASKIN RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-3905
Country	:	US
Telephone Number	:	757-395-6900
Fax Number	:	757-425-7180

Provider Business Practice Location Address
First Line	:	303 35TH ST
Second Line	:	SUITE 102
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-2868
Country	:	US
Telephone Number	:	757-395-6900
Fax Number	:	757-425-7180

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. CINDY A TAYLOR
Credential	:
Telephone Number	:	757-252-3344

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	04/23/2020

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Directions to “SENTARA MEDICAL GROUP ” Practice Location

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