Organization
SENTARA MEDICAL GROUP
Active
Other names
Sentara Podiatry Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DORIS A PRINCE (DIRECTOR)
(757) 983-5475
Entity
Organization
Contact information
Practice address
844 KEMPSVILLE RD, STE 104, NORFOLK, VA 23502-3927
(757) 261-0041
(757) 431-7770
Mailing address
844 KEMPSVILLE RD, STE 104, NORFOLK, VA 23502-3927
(757) 261-0041
(757) 431-7770
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
213E00000X
Podiatrist
Primary
—
VA
332B00000X
Durable Medical Equipment & Medical Supplies
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02033
MEDICARE GROUP NUMBER
VA
Enumeration date
09/25/2014
Last updated
05/24/2021
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