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Organization

COASTAL SURGICAL SPECIALISTS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BASIL S SKENDERIS II M.D. (PHYSICIAN ADMINISTRATOR)
(757) 481-4424
Entity
Organization

Contact information

Practice address
1120 FIRST COLONIAL RD, SUITE 203, VIRGINIA BEACH, VA 23454-2418
(757) 481-4424
(757) 481-3820
Mailing address
1120 FIRST COLONIAL RD, SUITE 203, VIRGINIA BEACH, VA 23454-2418
(757) 481-4424
(757) 481-3820

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
300012
OPTIMA VENDER #
VA
01
5975074
AETNA
VA
05
89013HR
NC
Enumeration date
12/26/2006
Last updated
08/11/2010
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