Doctor Name: | DR. KEVIN HALISTA |
NPI Number: | 1013976075 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 0101049901 |
Business Practice Address: | 110 Kingsley Ln Suite 305 Norfolk, VA - 235054614 |
Business Phone Number: | 8042626900 |
Business Fax Number: | |
Mailing Address: | Po Box 15539, RICHMOND |
State: | VA |
Postal Code: | 232275539 |
Phone Number: | 8042626900 |
Fax Number: | |
NPI Enumeration Date: | 03/20/2006 |
NPI Last Update Date: | 07/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 0101049901 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |