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Organization

NANSEMOND FAMILY PRACTICE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DONALD ELWOOD SOLES JR. M.D. (MEMBER)
(757) 365-9090
Entity
Organization

Contact information

Practice address
206 GUMWOOD DR, SUITE A, SMITHFIELD, VA 23430-6087
(757) 365-9090
(757) 365-9095
Mailing address
206 GUMWOOD DR, SUITE A, SMITHFIELD, VA 23430-6087
(757) 365-9090
(757) 365-9095

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101045475
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005600367
VA
01
24513
OPTIMA HEALTH/SENTARA
VA
01
431477
ANTHEM
VA
Enumeration date
10/24/2006
Last updated
01/14/2011
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