Organization
INTERNAL MEDICINE OF PORTSMOUTH LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA B LAUVER (PRACTICE MANAGER)
(757) 399-7751
Entity
Organization
Contact information
Practice address
3300 HIGH ST, SUITE 6, PORTSMOUTH, VA 23707-3321
(757) 399-7751
(757) 393-0743
Mailing address
3300 HIGH ST, SUITE 6, PORTSMOUTH, VA 23707-3321
(757) 399-7751
(757) 393-0743
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200207
OPTIMA/SENTARA
VA
01
—
46841
ANTHEM
VA
01
—
AS07402850001
CIGNA
VA
01
—
CM8153
RAILROAD MEDICARE
—
Enumeration date
10/09/2006
Last updated
04/17/2015
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