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Individual

MARK R WINTERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
351 EDWIN DR, SUITE 102, VIRGINIA BEACH, VA 23462-4559
(757) 499-5550
(757) 473-0919
Mailing address
860 OMNI BLVD STE 101, NEWPORT NEWS, VA 23606-4430
(757) 232-8769
(757) 232-8875

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101033310
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010014859
VA
01
462018
ANTHEM
VA
01
P00136766
RR/MEDICARE
Enumeration date
11/08/2005
Last updated
02/07/2020
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