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Organization

PULMONARY CONSULTANTS OF TIDEWATER PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEVEN HOWARD KAUFMAN MD (PRESIDENT)
(757) 547-9451
Entity
Organization

Contact information

Practice address
113 GAINSBOROUGH SQ, SUITE 300, CHESAPEAKE, VA 23320-1713
(757) 547-9451
(757) 547-1405
Mailing address
113 GAINSBOROUGH SQ, SUITE 300, CHESAPEAKE, VA 23320-1713
(757) 547-9451
(757) 547-1405

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
0101031986
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02473
BLUE CROSS AND BLUE SHIEL
NC
01
042676
ANTHEM
VA
01
149069300
OWCP
VA
05
8902473
NC
01
CA6719
RAILROAD MEDICARE
VA
Enumeration date
01/18/2007
Last updated
02/14/2012
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