Individual
CEDRIC D PINCKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 GRESHAM DR, SUITE 503, NORFOLK, VA 23507-1901
(757) 623-7575
Mailing address
400 GRESHAM DR, SUITE 503, NORFOLK, VA 23507-1901
(757) 623-7575
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101050934
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007303874
—
VA
01
—
054985
BC/BS
VA
01
—
45066
OPTIMA
VA
Enumeration date
04/16/2007
Last updated
01/28/2021
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