Organization
AFFINITY HEALTHCARE GROUP NEWTOWN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD A MARTIN JR. (REGIONAL DIRECTOR)
(757) 962-0748
Entity
Organization
Contact information
Practice address
5715 PRINCESS ANNE RD, #106-107, VIRGINIA BEACH, VA 23462-3222
(757) 962-0748
(757) 962-0876
Mailing address
5715 PRINCESS ANNE RD, #106-107, VIRGINIA BEACH, VA 23462-3222
(757) 962-0748
(757) 962-0876
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102201920
VA
207QA0401X
Addiction Medicine (Family Medicine) Physician
207QA0401X
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F092
MEDICARE PTAN
VA
Enumeration date
02/20/2015
Last updated
11/17/2015
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