Organization
TIDEWATER INTEGRATED MEDICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD THOMAS MD (DOCTOR)
(757) 340-3489
Entity
Organization
Contact information
Practice address
VIRGINIA BEACH GENERAL HOSPITAL, 1060 FIRST COLONIAL RD, VIRGINIA BEACH, VA 23450
(757) 340-3489
(757) 340-4278
Mailing address
PO BOX 2546, VIRGINIA BEACH, VA 23450-2546
(757) 340-3489
(757) 340-4278
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528007010
—
VA
Enumeration date
06/06/2006
Last updated
03/09/2015
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