Organization
SENTARA MEDICAL GROUP
Active
Other names
Sentara Neurology Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS PRINCE (DIRECTOR)
(757) 983-5475
Entity
Organization
Contact information
Practice address
5659 PARKWAY DR, STE 230, GLOUCESTER, VA 23061-3782
(804) 210-1055
(804) 210-1059
Mailing address
5659 PARKWAY DR, STE 230, GLOUCESTER, VA 23061-3782
(804) 210-1055
(804) 210-1059
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02033
MEDICARE GROUP NUMBER
VA
Enumeration date
01/07/2009
Last updated
10/28/2021
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