# TIDEWATER TLC FAMILY CARE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386632495
- **Authorized official:** VANESSA A BLOWE MD FAAFP (PRACTICE OWNER DOCTOR)
- **Authorized official phone:** (757) 436-6959

## Contact information

- **Practice address:** 745 BATTLEFIELD BLVD N, CHESAPEAKE, VA 23320-0305
- **Practice address phone:** (757) 436-6959
- **Practice address fax:** (757) 549-1933
- **Mailing address:** 745 BATTLEFIELD BLVD N, CHESAPEAKE, VA 23320-0305
- **Mailing address phone:** (757) 436-6959
- **Mailing address fax:** (757) 549-1933

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/12/2005
- **Last updated:** 08/22/2020