Organization
SENTARA MEDICAL GROUP
Active
Other names
Sentara Specialty Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY A TAYLOR (MANAGER)
(757) 252-3344
Entity
Organization
Contact information
Practice address
5659 PARKWAY DR, STE 200, GLOUCESTER, VA 23061-3792
(757) 259-5120
(757) 510-9063
Mailing address
5659 PARKWAY DR, STE 200, GLOUCESTER, VA 23061-3792
(757) 259-5120
(757) 510-9063
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02033
MEDICARE GROUP NUMBER
VA
Enumeration date
10/06/2011
Last updated
10/06/2011
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