# TIDEWATER HYPERBARIC

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

## Provider details

- **NPI number:** 1598282998
- **Authorized official:** CARA MAE MELTON (PRESIDENT)
- **Authorized official phone:** (757) 383-3728

## Contact information

- **Practice address:** 129 WEST VIRGINIA BEACH BLVD, SUITE 140 A, NORFOLK, VA 23510
- **Practice address phone:** (757) 452-3935
- **Mailing address:** 129 W VIRGINIA BEACH BLVD STE 140A, NORFOLK, VA 23510-2030

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | NULL | Yes |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/25/2017
- **Last updated:** 08/25/2017