Individual
DR. PRABU SELVAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20480 MARKET ST, ONANCOCK, VA 23417-4309
(757) 302-2350
(757) 789-0615
Mailing address
856 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1318
(757) 316-5800
(757) 534-5190
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101259565
VA
207P00000X
Emergency Medicine Physician
D90789
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2014
Last updated
03/01/2021
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