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Organization

TIDEWATER SKIN CARE AND PATHOLOGY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PADMAN A MENON MD (PRESIDENT)
(757) 825-1846
Entity
Organization

Contact information

Practice address
1157 FIRST COLONIAL RD, SUITE 300, VIRGINIA BEACH, VA 23454-2432
(757) 333-8001
(757) 333-8002
Mailing address
1157 FIRST COLONIAL RD, SUITE 300, VIRGINIA BEACH, VA 23454-2432
(757) 333-8001
(757) 333-8002

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101022994
VA
207N00000X
Dermatology Physician
200301017
NC

Other

Enumeration date
02/04/2010
Last updated
12/20/2010
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