Organization
SENTARA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY A TAYLOR (MANAGER)
(757) 252-2765
Entity
Organization
Contact information
Practice address
2760 GODWIN BLVD STE 100, SUFFOLK, VA 23434-8036
(757) 983-8650
(757) 983-8673
Mailing address
2760 GODWIN BLVD STE 100, SUFFOLK, VA 23434-8036
(757) 983-8650
(757) 538-9038
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02033
MEDICARE GROUP NUMBER
VA
Enumeration date
12/10/2013
Last updated
03/17/2018
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