NPI 1215269097

Tidewater Skin Care and Pathology PC

Organisation Dermatology Physician Virginia Beach, VA

Practice location

Address: 1157 First Colonial Rd Suite 300, Virginia Beach, VA 23454-2432
Phone: (757) 333-8001
Fax: (757) 333-8002

Authorised official

Name: Padman a Menon
Title: President
Phone: (757) 825-1846

Registered specialties (2)

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 0101022994 (VA)

Other Dermatology providers in Virginia →

Dermatology Physician

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 200301017 (NC)

Registry record

NPI: 1215269097
Entity type: Organization
NPI issued: 4 Feb 2010
Record last updated: 20 Dec 2010

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.