Organization
HAMPTON ROADS INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY LESTER ROTHFUSS M.D. (PRESIDENT)
(757) 827-1920
Entity
Organization
Contact information
Practice address
2115 EXECUTIVE DR, SUITE 2A, HAMPTON, VA 23666-2499
(757) 827-1920
(757) 827-7509
Mailing address
2115 EXECUTIVE DRIVE, SUITE 2A, HAMPTON, VA 23666-2411
(757) 827-1920
(757) 827-7509
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101033520
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C10327
MEDICARE PTAN
—
Enumeration date
11/05/2007
Last updated
12/28/2007
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