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Organization
MARY IMMACULATE HOSPITAL
Active
Organization
MARY IMMACULATE HOSPITAL
Active
Other names
DBA BON SECOURS PALLIATIVE MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN SMITH (CREDENTIALING SPECIALIST)
(757) 215-2784
Entity
Organization
Contact information
Practice address
12720 MCMANUS BLVD, SUITE 301, NEWPORT NEWS, VA 23602-4414
(757) 947-3838
(757) 327-4280
Mailing address
7007 HARBOUR VIEW BLVD, SUITE 108, SUFFOLK, VA 23435-3657
(757) 215-2784
(757) 215-2728
Taxonomy
Speciality
Code
Description
License number
State
207VH0002X
Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
Primary
—
NULL
207VH0002X
Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
Primary
—
—
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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