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Individual

MRS. ELIZABETH W WYNEGAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
844 KEMPSVILLE RD, SUITE 204, NORFOLK, VA 23502-3927
(757) 261-0700
(757) 962-1254
Mailing address
300 MEDICAL PKWY, STE 120, CHESAPEAKE, VA 23320-4985
(757) 252-5660
(757) 548-9443

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0110001872
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010201616
VA
01
184972
ANTHEM MEDIGAP
VA
Enumeration date
08/10/2006
Last updated
08/25/2016
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