Organization
TIDEWATER BARIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARGARET MACKRELL GAGLIONE M.D. (MEDICAL DIRECTOR)
(757) 644-6819
Entity
Organization
Contact information
Practice address
1413 KEMPSVILLE RD, CHESAPEAKE, VA 23320-8134
(757) 644-6819
(757) 644-6816
Mailing address
1413 KEMPSVILLE RD, CHESAPEAKE, VA 23320-8134
(757) 644-6819
(757) 644-6816
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
0101050879
VA
Other
Enumeration date
01/28/2010
Last updated
01/28/2010
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