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Organization

TIDEWATER FAMILY MEDICAL CARE, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FRANK JOSEPH PICCIONI D.O. (PRESIDENT)
(757) 495-0606
Entity
Organization

Contact information

Practice address
516 INNOVATION DR, STE 103, CHESAPEAKE, VA 23320-3847
(757) 495-0606
Mailing address
516 INNOVATION DR, STE. 103, CHESAPEAKE, VA 23320-3847
(757) 495-0606
(757) 495-0952

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102037087
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10139414
VA
01
131473
OPTIMA ID
VA
01
172725
ANTHEM BCBS ID
VA
Enumeration date
02/23/2007
Last updated
07/14/2008
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