Organization
SENTARA MEDICAL GROUP
Active
Other names
Sentara Podiatry Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY A TAYLOR (MANAGER)
(757) 252-2765
Entity
Organization
Contact information
Practice address
2790 GODWIN BLVD, STE 355, SUFFOLK, VA 23434-8151
(757) 983-8520
(757) 579-8643
Mailing address
2790 GODWIN BLVD, STE 355, SUFFOLK, VA 23434-8151
(757) 983-8520
(757) 579-8643
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
VA
332B00000X
Durable Medical Equipment & Medical Supplies
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02033
MEDICARE GROUP NUMBER
VA
Enumeration date
08/31/2016
Last updated
08/31/2016
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