Organization
COASTAL PROSTHETICS AND ORTHOTICS, LLC
Active
Organization
COASTAL PROSTHETICS AND ORTHOTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE A SIVERD C.P.O. (PRESIDENT)
(757) 892-5300
Entity
Organization
Contact information
Practice address
11818 ROCK LANDING DR, STE#104, NEWPORT NEWS, VA 23606-4230
(757) 892-5300
(757) 892-5303
Mailing address
11818 ROCK LANDING DR, STE#104, NEWPORT NEWS, VA 23606-4230
(757) 892-5300
(757) 892-5303
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
N/A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1029129
ACM
VA
01
—
194379
ANTHEM BCBS
VA
01
—
39563
SENTARA
VA
05
—
7703398
—
VA
05
—
9190414
—
VA
Enumeration date
08/13/2006
Last updated
03/26/2014
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