Organization
BAYSIDE INTERNAL MEDICINE PLC
Active
Organization
BAYSIDE INTERNAL MEDICINE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STARR NICHOLS CPC (BILLING MANAGER)
(757) 363-3001
Entity
Organization
Contact information
Practice address
1020 INDEPENDENCE BLVD, SUITE 105, VIRGINIA BEACH, VA 23455-5500
(757) 318-3700
(757) 318-3701
Mailing address
1020 INDEPENDENCE BLVD, SUITE 105, VIRGINIA BEACH, VA 23455-5500
(757) 318-3700
(757) 318-3701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB3911
MEDICARE RAILROAD
VA
Enumeration date
10/15/2006
Last updated
05/02/2013
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