Organization
TIDEWATER ALLERGY AND ASTHMA LLC
Active
Other names
Tidewater Allery and Asthma
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY RAY OWENS MD (OWNER)
(757) 572-6052
Entity
Organization
Contact information
Practice address
4534 BONNEY RD STE B, VIRGINIA BEACH, VA 23462-3873
(757) 499-4101
(757) 497-2419
Mailing address
1828 DUKE OF NORFOLK QUAY, VIRGINIA BEACH, VA 23454-1106
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Enumeration date
01/14/2025
Last updated
04/03/2025
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