Organization
FORT NORFOLK PLAZA MEDICAL ASSOCIATES, LLC
Active
Other names
Fort Norfolk Plaza Primary Care, PC
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY NEWBY (CFO)
(757) 624-1785
Entity
Organization
Contact information
Practice address
301 RIVERVIEW AVENUE, SUITE 525, NORFOLK, VA 23510-1064
(757) 227-6866
(757) 277-0298
Mailing address
301 RIVERVIEW AVENUE, SUITE 504, NORFOLK, VA 23510-1064
(757) 227-6866
(757) 743-1974
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VAA103549
GROUP PTAN
—
Enumeration date
11/16/2009
Last updated
06/30/2020
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