Organization
INFECTIOUS DISEASE SPECIALISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN SMITH (CREDENTIALING MANAGER)
(502) 244-9859
Entity
Organization
Contact information
Practice address
224 AVONLEA POINTE, CHESAPEAKE, VA 23322-4279
(757) 967-7288
(757) 520-4675
Mailing address
224 AVONLEA POINTE, CHESAPEAKE, VA 23322-4279
(757) 967-7288
(757) 520-4675
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101246938
STATE LICENSE
VA
Enumeration date
06/04/2020
Last updated
06/04/2020
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