Organization
EASTERN VIRGINIA RHEUMATOLOGY PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID B MAXWELL MD (PRESIDENT)
(757) 595-2040
Entity
Organization
Contact information
Practice address
11747 JEFFERSON AVE, SUITE 4E, NEWPORT NEWS, VA 23606-1998
(757) 595-2040
(757) 591-8260
Mailing address
PO BOX 11768, RICHMOND, VA 23230-0168
(804) 545-6862
(804) 213-9783
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006031455
—
VA
Enumeration date
03/24/2006
Last updated
03/18/2010
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