NPI 1851488167
Emergency Physician of Tidewater
Practice location
- Address
- 4092 Foxwood Dr Suite 101, Virginia Beach, VA 23462-5225
- Phone
- (757) 467-4200
- Fax
- (757) 467-4173
- Mailing address
- 309 Downing Dr, Chesapeake, VA 23322-8703
Authorised official
- Name
- Aksel Keklik
- Title
- Physician Assistant
- Phone
- (757) 410-8879
Registered specialties
General Acute Care Hospital
Primary
Registry record
- NPI
- 1851488167
- Entity type
- Organization
- NPI issued
- 6 Oct 2006
- Record last updated
- 22 Aug 2020
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.