Organization
TIDEWATER PHYSICIANS MULTISPECIALTY GROUP PC
Active
Parent organization
TIDEWATER PHYSICIANS MULTISPECIALTY GROUP, PC
Other names
Tidewater Physicians Multispecialty Group- Newtown Medical, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TIDEWATER PHYSICIANS MULTISPECIALTY GROUP, PC
Authorized official
CECILIA QUINTERO (CREDENTIALING MANAGER)
(757) 964-8739
Entity
Organization
Contact information
Practice address
5424 DISCOVERY PARK BLVD, BUILDING B, SUITE 105, WILLIAMSBURG, VA 23188-2862
(757) 345-5870
(757) 345-6927
Mailing address
860 OMNI BLVD STE 8, NEWPORT NEWS, VA 23606-4434
(757) 964-8739
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/13/2009
Last updated
03/26/2026
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