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Organization
COASTAL MEDSURG, INC.
Active
Organization
COASTAL MEDSURG, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD WILSON CSA, RSA (PRESIDENT)
(757) 672-3738
Entity
Organization
Contact information
Practice address
1700 WILL O WISP DR, VIRGINIA BEACH, VA 23454-3164
(757) 496-6400
Mailing address
604 BISHOP DR, VIRGINIA BEACH, VA 23455-6544
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
NULL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
10/25/2018
Last updated
10/25/2018
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