Organization
TIDEWATER ENDOCRINOLOGY LLC
Active
Other names
ENDOCRINOLOGY AND DIABETES CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES CALVIN LAROCQUE M.D. (OWNER)
(757) 484-7822
Entity
Organization
Contact information
Practice address
3205 CHURCHLAND BLVD, CHESAPEAKE, VA 23321-5205
(757) 484-7822
(757) 484-7362
Mailing address
3205 CHURCHLAND BLVD, CHESAPEAKE, VA 23321-5205
(757) 484-7822
(757) 484-7362
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
0101034393
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639599723
GROUP NPI
VA
Enumeration date
04/16/2014
Last updated
06/20/2014
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