Individual
JOSELIN D TACASTACAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1601 COMMONWEALTH AVE, WILLIAMSBURG, VA 23185-5125
(757) 259-9466
(757) 259-7907
Mailing address
11844 ROCK LANDING DR STE B, NEWPORT NEWS, VA 23606-4206
(757) 873-0161
(757) 873-0205
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101236219
VA
207R00000X
Internal Medicine Physician
010236219
VA
207R00000X
Internal Medicine Physician
MD28115
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010087000
FEDERAL BLACK LUNG
—
05
—
010110831
—
VA
05
—
010110866
—
VA
05
—
010158192
—
VA
01
—
177346
BLUE CROSS
VA
01
—
VA0105
JOHN DEERE
VA
Enumeration date
05/08/2006
Last updated
05/08/2024
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