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Organization

OLDE TOWNE MEDICAL PRACTICE PLLC

Active
Other names
Bhowik Medical Practice
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LATISHA BYRD (OFFICE BILLING CLERK)
(757) 399-0701
Entity
Organization

Contact information

Practice address
301 GOODE WAY STE 103, PORTSMOUTH, VA 23704-2266
(757) 399-0701
(757) 399-3731
Mailing address
301 GOODE WAY STE 103, PORTSMOUTH, VA 23704-2266
(757) 399-0701
(757) 399-3731

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
07/08/2024
Last updated
07/08/2024
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