Organization · NPI-2

Sentara Medical Group

Podiatrist · Norfolk, VA

NPI number1487056115
StatusActive
Last updated in NPPESMay 24, 2021

Details

NPI
1487056115
Entity type
Organization (NPI-2)
Legal business name
Sentara Medical Group
Organization subpart
No
Enumeration date
Sep 25, 2014
Certification date
May 24, 2021
Last updated
May 24, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213E00000X Podiatrist–VAYes
207RS0010X Internal Medicine, Sports Medicine––
332B00000X Durable Medical Equipment & Medical Supplies–VA

Other names

  • Sentara Podiatry Specialists (Doing Business As)

Practice location

844 Kempsville Rd
Ste 104
Norfolk, VA 23502-3927

Phone 757-261-0041 · Fax 757-431-7770

Mailing address

844 Kempsville Rd
Ste 104
Norfolk, VA 23502-3927

Phone 757-261-0041 · Fax 757-431-7770

Authorized official

Doris A Prince
Director
7579835475

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