Organization
WARD'S CORNER PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA EARLENE AVILA (OWNER)
(757) 779-1955
Entity
Organization
Contact information
Practice address
7423 GRANBY ST, NORFOLK, VA 23505-3406
(757) 451-5000
Mailing address
7423 GRANBY ST, NORFOLK, VA 23505-3406
(757) 451-5000
(757) 451-5007
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006705243
—
VA
05
—
006747558
—
VA
05
—
1518144492
—
VA
05
—
1578512091
—
VA
05
—
1811261332
—
VA
Enumeration date
10/08/2012
Last updated
06/17/2025
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