Individual
THOMAS J. SHACOCHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
858 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1303
(757) 594-4343
(757) 594-4321
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
(757) 594-4006
(757) 534-5190
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101024150
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093779423
—
VA
Enumeration date
04/13/2006
Last updated
05/17/2011
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