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Organization
MID ATLANTIC LONG TERM SPECIALTY CARE LLC
Active
Organization
MID ATLANTIC LONG TERM SPECIALTY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NABIL TADROS MD (SOLE MEMBER)
(757) 354-2885
Entity
Organization
Contact information
Practice address
6160 KEMPSVILLE CIR STE 325A, NORFOLK, VA 23502-3933
(757) 354-2885
(757) 917-5141
Mailing address
6160 KEMPSVILLE CIR STE 325A, NORFOLK, VA 23502-3933
(757) 354-2885
(757) 917-5141
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
NULL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
NULL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
NULL
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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