Organization
TIDEWATER MEDICAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS G. CARPIO M.D. (PRESIDENT)
(757) 549-9671
Entity
Organization
Contact information
Practice address
111 COASTAL WAY, CHESAPEAKE, VA 23320-4603
(757) 549-9671
(757) 549-6802
Mailing address
111 COASTAL WAY, CHESAPEAKE, VA 23320-4603
(757) 549-9671
(757) 549-6802
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101055402
VA
Other
Enumeration date
03/23/2007
Last updated
08/22/2020
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