Organization
COASTAL PLASTIC SURGERY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN R. CARWELL JR. M.D. (PRESIDENT)
(757) 481-7788
Entity
Organization
Contact information
Practice address
1200 FIRST COLONIAL RD, SUITE 100, VIRGINIA BEACH, VA 23454-2274
(757) 481-7788
(757) 481-1707
Mailing address
1200 FIRST COLONIAL RD, SUITE 100, VIRGINIA BEACH, VA 23454-2274
(757) 481-7788
(757) 481-1707
Taxonomy
Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
0101025726
VA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
0101025726
VA
Other
Enumeration date
08/09/2010
Last updated
08/31/2016
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