Individual
DR. PHILIP JOHN GENTLESK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 RIVERVIEW AVE STE 700, NORFOLK, VA 23510-1065
(757) 252-9365
(757) 962-7217
Mailing address
301 RIVERVIEW AVE STE 700, NORFOLK, VA 23510-1065
(757) 252-9365
(757) 962-7217
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
0101247596
VA
207RC0000X
Cardiovascular Disease Physician
M2328
TX
207RC0000X
Cardiovascular Disease Physician
MD421833
PA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
0101247596
VA
207RC0001X
Clinical Cardiac Electrophysiology Physician
M2328
TX
207RC0001X
Clinical Cardiac Electrophysiology Physician
MD421833
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10065070
SENTARA OPTIMA HEALTH (EVMS HEALTH SERVICES)
VA
05
—
1528059862
—
VA
05
—
189409901
—
TX
Enumeration date
11/04/2005
Last updated
07/15/2022
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