Organization
SENTARA MEDICAL GROUP
Active
Other names
New Town Diagnostic Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY A TAYLOR (MANAGER)
(757) 252-3344
Entity
Organization
Contact information
Practice address
4374 NEW TOWN AVE, SUITE 104, WILLIAMSBURG, VA 23188-2865
(757) 259-1335
(757) 259-1395
Mailing address
4374 NEW TOWN AVE, SUITE 104, WILLIAMSBURG, VA 23188-2865
(757) 259-1335
(757) 259-1395
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
49D1080933
VA
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02033
MEDICARE GROUP NUMBER
VA
Enumeration date
02/06/2008
Last updated
11/29/2011
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