Organization
MID ATLANTIC LONG TERM CARE SPECIALISTS LLC
Active
Other names
Tidewater Infectious Disease Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
AMIR HAJIMOMENIAN 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
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RI0200X
Infectious Disease Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/15/2020
Last updated
09/21/2020
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