Organization
MIDDLE PENINSULA MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS L. WATHEN (VICE PRESIDENT)
(804) 384-7902
Entity
Organization
Contact information
Practice address
9184 BUCKLEY HALL RD, MATHEWS, VA 23109-2309
(804) 725-0100
(804) 725-3158
Mailing address
PO BOX 1498, MATHEWS, VA 23109-1498
(804) 725-0100
(804) 725-3158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/03/2016
Last updated
11/04/2016
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