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Organization

BON SECOURS DEPAUL MEDICAL CENTER

Active
Parent organization
BON SECOURS DEPAUL MEDICAL CENTER
Other names
DePaul/EVMS Otolaryngology Head and Neck Surgery
Organization subpart
Yes

Provider details

NPI number
Legal business name
BON SECOURS DEPAUL MEDICAL CENTER
Authorized official
MICHAEL K KERNER (CEO)
(757) 673-5929
Entity
Organization

Contact information

Practice address
100 KINGSLEY LN, SUITE 404, NORFOLK, VA 23505-4604
(757) 889-5632
(757) 889-5633
Mailing address
100 KINGSLEY LN, SUITE 404, NORFOLK, VA 23505-4604
(757) 889-5632
(757) 889-5633

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary

Other

Enumeration date
05/25/2012
Last updated
06/26/2012
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