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Organization
TIDEWATER ALLERGY AND ASTHMA LLC
Active
Organization
TIDEWATER ALLERGY AND ASTHMA LLC
Active
Other names
Tidewater Allery and Asthma
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY RAY OWENS MD (OWNER)
(757) 572-6052
Entity
Organization
Contact information
Practice address
4534 BONNEY RD STE B, VIRGINIA BEACH, VA 23462-3873
(757) 499-4101
(757) 497-2419
Mailing address
1828 DUKE OF NORFOLK QUAY, VIRGINIA BEACH, VA 23454-1106
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Enumeration date
01/14/2025
Last updated
04/03/2025
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