Organization Name: | SENTARA MEDICAL GROUP |
NPI Number: | 1083073464 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CINDY A TAYLOR (MANAGER) |
Mailing Address: | 3920 Bridge Rd Ste 202 Suffolk |
State: | VA US |
Postal Code: | 234351117 |
Phone Number: | 7573951600 |
Fax Number: | 7575109136 |
NPI Enumeration Date: | 02/15/2016 |
NPI Last Update Date: | 02/15/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2086S0129X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Surgery |
Taxonomy Specialization: | Vascular Surgery |
Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |