Individual
EDILBERTO OLARTE PELAUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 MEADE PARKWAY, SUFFOLK, VA 23434-4259
(757) 539-0251
(757) 934-9421
Mailing address
PO BOX 7068, PORTSMOUTH, VA 23707-0068
(757) 686-3508
(757) 686-0541
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101057813
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02857505
—
NY
01
—
040015729
RAILROAD MEDICARE
VA
05
—
6500218
—
VA
05
—
890519M
—
NC
Enumeration date
04/24/2006
Last updated
03/06/2013
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