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Organization
TIDEWATER KIDNEY SPECIALISTS, INC.
Active
Organization
TIDEWATER KIDNEY SPECIALISTS, INC.
Active
Other names
Tidewater Vascular Access Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH F SKIDMORE (PRACTICE ADMINISTRATOR)
(757) 623-0005
Entity
Organization
Contact information
Practice address
814 KEMPSVILLE RD, SUITE 101, NORFOLK, VA 23502-4001
(757) 623-0005
(757) 548-1129
Mailing address
4445 CORPORATION LN STE 100, VIRGINIA BEACH, VA 23462-3666
(757) 623-0005
(757) 548-1129
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
04/18/2012
Last updated
01/20/2022
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