Organization
SENTARA MEDICAL GROUP
Active
Other names
First Colonial Diagnostic Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY A TAYLOR (MANAGER)
(757) 252-3344
Entity
Organization
Contact information
Practice address
1080 FIRST COLONIAL RD, SUITE 100, VIRGINIA BEACH, VA 23454-2406
(757) 395-6464
(757) 395-6490
Mailing address
1080 FIRST COLONIAL RD, SUITE 100, VIRGINIA BEACH, VA 23454-2406
(757) 395-6464
(757) 395-6490
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
49D0981411
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00393284
RR MEDICARE PIN
VA
Enumeration date
06/05/2006
Last updated
09/23/2011
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