Organization
LIFEWAY FAMILY PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEIRDRE BARNES (MANAGER)
(757) 496-4916
Entity
Organization
Contact information
Practice address
1821 OLD DONATION PKWY, SUITE #4, VIRGINIA BEACH, VA 23454-3033
(757) 496-4916
(757) 496-4046
Mailing address
1821 OLD DONATION PKWY, SUITE #4, VIRGINIA BEACH, VA 23454-3033
(757) 496-4916
(757) 496-4046
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080008247
MEDICARE NUMBER
VA
01
—
1194806307
MEDICARE NUMBER
VA
01
—
1205801719
MEDICARE NUMBER
VA
Enumeration date
11/07/2006
Last updated
04/09/2015
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