TIDEWATER PHYSICIANS MULTISPECIALTY GROUP PC NPI 1902848294

NPI Information

NPI: 1902848294
Provider Name: TIDEWATER PHYSICIANS MULTISPECIALTY GROUP PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
860 OMNI BLVD STE 401
NEWPORT NEWS, VA
ZIP 23606
Phone: (757) 232-8764
Get Directions

TIDEWATER PHYSICIANS MULTISPECIALTY GROUP PC is a family medicine in Newport News, VA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. TIDEWATER PHYSICIANS MULTISPECIALTY GROUP PC NPI is 1902848294. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

860 OMNI BLVD STE 401
NEWPORT NEWS, VA
ZIP 23606-430
Phone: (757) 232-8764

The provider's authorized official is Angela Walker .
The authorized official title is Credentialing Coordinator and has the following contact phone number (757) 232-8769.

The enumeration date for this NPI number is 6/12/2006 and was last updated on 12/15/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine				No
2	207RE0101X	Internal Medicine	Endocrinology, Diabetes & Metabolism	182340975	VIRGINIA	No
3	207RG0100X	Internal Medicine	Gastroenterology			No
4	207RN0300X	Internal Medicine	Nephrology	223741512	VIRGINIA	No
5	207RR0500X	Internal Medicine	Rheumatology	229641543	VIRGINIA	No
6	207V00000X	Obstetrics & Gynecology				No
7	207W00000X	Ophthalmology				No
8	207X00000X	Orthopaedic Surgery				No
9	2085R0202X	Radiology	Diagnostic Radiology			No
10	208600000X	Surgery				No
11	208800000X	Urology				No
12	213ES0131X	Podiatrist	Foot Surgery	0103300835	VIRGINIA	No
13	291U00000X	Clinical Medical Laboratory				No
14	207Q00000X	Family Medicine				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CA6708	OTHER	VIRGINIA	RAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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