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Organization

MID ATLANTIC LONG TERM SPECIALTY CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NABIL TADROS MD (SOLE MEMBER)
(757) 354-2885
Entity
Organization

Contact information

Practice address
6160 KEMPSVILLE CIR STE 325A, NORFOLK, VA 23502-3933
(757) 354-2885
(757) 917-5141
Mailing address
6160 KEMPSVILLE CIR STE 325A, NORFOLK, VA 23502-3933
(757) 354-2885
(757) 917-5141

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
207Q00000X
Family Medicine Physician
207QG0300X
Geriatric Medicine (Family Medicine) Physician
207R00000X
Internal Medicine Physician
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner
363LA2200X
Adult Health Nurse Practitioner
363LG0600X
Gerontology Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
07/15/2020
Last updated
07/15/2020
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