Organization
CHESAPEAKE REGIONAL MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY IULIANO (BILLING MANAGER)
(757) 842-4481
Entity
Organization
Contact information
Practice address
534 CARATOKE HWY, MOYOCK, NC 27958-8740
(252) 435-6621
(252) 435-2685
Mailing address
667 KINGSBOROUGH SQ STE 101, CHESAPEAKE, VA 23320-4999
(757) 842-4481
(757) 312-3135
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
03/27/2009
Last updated
11/13/2024
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