Organization
TIDEWATER PHYSICIANS MULTISPECIALTY GROUP
Active
Parent organization
TIDEWATER PHYISICIANS MULTISPECIALTY GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
TIDEWATER PHYISICIANS MULTISPECIALTY GROUP
Authorized official
CECILIA QUINTERO (CREDENTIALING MANAGER)
(757) 964-8739
Entity
Organization
Contact information
Practice address
11751 ROCK LANDING DR STE 6, NEWPORT NEWS, VA 23606-4233
(757) 327-0657
(757) 327-0658
Mailing address
860 OMNI BLVD STE 8, NEWPORT NEWS, VA 23606-4434
(757) 964-8739
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/19/2009
Last updated
03/11/2026
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