Individual
DR. EDWIN EDISON GATEWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
825 FAIRFAX AVE, SUITE 710, NORFOLK, VA 23507-1914
(757) 446-5888
(757) 446-5918
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5269
(757) 953-6907
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101054731
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-006
TRICARE/CHAMPUS
VA
05
—
007110600
—
VA
01
—
0520K
BC/BS
NC
01
—
120503
VALUE OPTIONS
—
01
—
155139
MHN
—
01
—
209852
MAGELLAN
—
01
—
263582
UHC/MAMSI
VA
01
—
283237
ANTHEM
VA
05
—
690520K
—
NC
01
—
89030
SENTARA / OPTIMA
VA
01
—
PAR
FIRST HEALTH COMMERCIAL
VA
Enumeration date
02/15/2006
Last updated
10/22/2020
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