Organization
VIRGINIA BEACH SURGERY, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE MARTIN (PRACTICE MANAGER)
(757) 481-2313
Entity
Organization
Contact information
Practice address
1020 FIRST COLONIAL RD, VIRGINIA BEACH, VA 23454-3002
(757) 481-2313
Mailing address
PO BOX 4159, VIRGINIA BEACH, VA 23454-0159
(757) 481-2313
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
10/23/2012
Last updated
10/23/2012
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