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Individual

DR. JAMES W MINK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
171 KEMPSVILLE RD, BUILDING B, NORFOLK, VA 23502-4700
(757) 668-6500
Mailing address
171 KEMPSVILLE RD, BUILDING B, NORFOLK, VA 23502-4700
(757) 668-6500

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101040562
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
006710948
VA PREMIER
05
006710948
VA
01
13841
OPTIMA
01
233006
MDIPA/MAMSI
01
330034
ANTHEM
01
541778786001
TRICARE
05
8906113
NC
Enumeration date
06/04/2006
Last updated
01/04/2013
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