Individual
DR. TED M KUBICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1024 FIRST COLONIAL RD, STE 102, VIRGINIA BEACH, VA 23454-3074
(757) 321-4080
(757) 275-9700
Mailing address
1024 FIRST COLONIAL RD, STE 102, VIRGINIA BEACH, VA 23454-3074
(757) 321-4080
(757) 275-9700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101053954
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005621348
—
VA
Enumeration date
02/21/2006
Last updated
12/06/2019
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