Individual
DR. TEOFILO CANO MASCARINAS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4501 NORTH WITCHDUCK ROAD, SUITE D, VIRGINIA BEACH, VA 23455-6217
(757) 490-2639
(757) 490-2517
Mailing address
4501 NORTH WITCHDUCK ROAD, SUITE D, VIRGINIA BEACH, VA 23455-6217
(757) 490-2639
(757) 490-2517
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101021848
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6049621
—
VA
Enumeration date
02/24/2006
Last updated
01/14/2010
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