Organization
COMMONWEALTH OF VIRGINIA/STATE BOARD OF HEALTH
Active
Other names
Peninsula Health District
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATASHA DWAMENA MD (HEALTH DIRECTOR)
(757) 594-7300
Entity
Organization
Contact information
Practice address
836 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1303
(757) 594-7305
(757) 594-7714
Mailing address
416 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1927
(757) 594-7305
(757) 594-7714
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
00240339042
VA
261QP0905X
State or Local Public Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4975103
—
VA
01
—
P00245240
PALMETTO GBA-MEDICARE
VA
Enumeration date
07/05/2005
Last updated
11/09/2023
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