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Organization

CHESAPEAKE BAY ENT PC

Active
Other names
COASTAL PLAIN ENT
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DETRA RENEE SAFFOLD (REGIONAL PRACTICE ADMINISTRATOR)
(757) 442-7040
Entity
Organization

Contact information

Practice address
36080 LANKFORD HWY, BELLE HAVEN, VA 23306-0000
(757) 442-7040
(757) 442-7080
Mailing address
1270 DIAMOND SPRINGS RD, SUITE 118, #712, VIRGINIA BEACH, VA 23455-3729
(757) 442-7040
(757) 442-7080

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006502903
VA
05
4102118 00
MD
Enumeration date
10/22/2007
Last updated
01/28/2014
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