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Individual

DEMETRIA MONTGOMERY LINDSAY

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1701 HIGH ST, SUITE 102, PORTSMOUTH, VA 23704-3103
(757) 393-8585
(757) 393-4807
Mailing address
1701 HIGH ST, PORTSMOUTH, VA 23704-3103
(757) 393-8585
(757) 393-4087

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101232375
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
49-7512-0
VA
01
4975120
SENTARA
VA
Enumeration date
03/10/2006
Last updated
07/08/2007
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