NPI 1013320712

Southeastern Virginia Areawide Model Program

Organisation Exclusive Provider Organization Norfolk, VA

Practice location

Address: 6350 Center Dr Suite101, Norfolk, VA 23502-4107
Phone: (757) 461-9481
Fax: (757) 461-1068

Authorised official

Name: John N Skirven
Title: Ceo
Phone: (757) 222-4510

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 1060267354 (VA)

Other Exclusive Provider Organization providers in Virginia →

Registry record

NPI: 1013320712
Entity type: Organization
NPI issued: 10 Jun 2014
Record last updated: 10 Jun 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.