DR. BRUCE WALDHOLTZ (NPI# 1871592840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871592840 |
| Entity Type | Individual |
| Full Name | DR. BRUCE WALDHOLTZ |
| Credential | M.D. |
| Practice Address |
113 Gainsborough Sq Ste 202 Chesapeake VA 23320-1714 |
| Mailing Address |
113 Gainsborough Sq Ste 101 Chesapeake VA 23320-1713 |
| Practice Telephone | 7574363285 |
| Practice Fax Number | 7574362262 |
| Mailing Telephone | 7574363285 |
| Mailing Fax Number | 7574322262 |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2019-05-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
0101042167 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | P00022692 | 01 | |
| SENTARA | 15925 | 01 | |
| ANTHEM | 325201 | 01 | |
| VA | 5821088 | 05 | |
| ANTHEM | 325204 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 113 Gainsborough Sq Ste 100, Chesapeake, VA 233201713 | 7574363285 | 7574362262 |
| Street Address |
113 GAINSBOROUGH SQ STE 202 |
| City | CHESAPEAKE |
| State | VA |
| Zip Code | 23320-1714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508865569 | Michael Sperling | Internal Medicine | 113 Gainsborough Sq Ste 202, Chesapeake, VA 23320-1714 | 2005-07-20 |
| 1326222928 | Paul Andrew Ricketts | Internal Medicine | 113 Gainsborough Sq Ste 202, Chesapeake, VA 23320-1714 | 2007-12-19 |
| 1306905328 | Janine E Brown | Nurse Practitioner | 113 Gainsborough Sq Ste 202, Chesapeake, VA 23320-1714 | 2006-12-06 |
| 1326028747 | Scott Lee Yagel | Internal Medicine | 113 Gainsborough Sq Ste 202, Chesapeake, VA 23320-1714 | 2006-01-20 |
| 1295734283 | Douglas H. Howerton | Internal Medicine | 113 Gainsborough Sq Ste 202, Chesapeake, VA 23320-1714 | 2005-07-20 |
| 1265431266 | Gary Payman | Internal Medicine | 113 Gainsborough Sq Ste 202, Chesapeake, VA 23320-1714 | 2005-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386263499 | Trinity Hospice 1, LLC | Hospice Care, Community Based | 1401 Kempsville Road, Suite A, Unit 1, Chesapeake, VA 23320 | 2020-04-09 |
| 1538624804 | Shaniqah Mcleod | Home Health | 217 Centerville Turnpike N, Chesapeake, VA 23320 | 2019-01-31 |
| 1942764113 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1400 Kempsville Rd, Virginia Beach, VA 23320 | 2019-01-22 |
| 1639647993 | Madison Vansavage Maben | Orthotist | 433 Network Sta, Chesapeake, VA 23320 | 2018-11-05 |
| 1568947356 | Kelly M Muchetti | Massage Therapist | 1421 C. Kempsville Rd., Chesapeake, VA 23320 | 2018-09-27 |
| 1235612912 | L&s Home Health Care, LLC. | Home Health | 1545 Cossways Blv, Chesepeake, VA 23320 | 2018-09-10 |
| 1154803500 | Latricia A Patterson | Home Health | 813-a Professional Pl Ste 107, Chesapeake, VA 23320 | 2018-09-02 |
| 1164909586 | 4k Tresses | Durable Medical Equipment & Medical Supplies | 1220 Executive Blvd Ste 101, Chesapeake, VA 23320 | 2018-07-27 |
| 1831676105 | Lance Taylor | Technician | 1645 Crossways Blvd Ste 250, Chesapeake, VA 23320 | 2018-07-19 |
| 1023507688 | Sentoria Howell Harold | Social Worker | 920 Ventures Way Ste 4, Chesapeake, VA 23320 | 2018-05-08 |
| Find all providers in zip 23320 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225246812 | Gastrointestinal and Liver Specialists of Tidewater Pllc | Internal Medicine | 113 Gainsborough Sq Ste 101, Chesapeake, VA 23320-1713 | 2007-05-18 |
| 1518941137 | Walid F Makdisi | Internal Medicine | 112 Gainsborough Sq, Suite 200, Chesapeake, VA 23320-1706 | 2005-12-06 |
| 1508865569 | Michael Sperling | Internal Medicine | 113 Gainsborough Sq Ste 202, Chesapeake, VA 23320-1714 | 2005-07-20 |
| 1326222928 | Paul Andrew Ricketts | Internal Medicine | 113 Gainsborough Sq Ste 202, Chesapeake, VA 23320-1714 | 2007-12-19 |
| 1356537054 | Rene Rivera | Internal Medicine | 112 Gainsborough Sq, Ste 200, Chesapeake, VA 23320-1706 | 2007-09-18 |
| 1265640726 | Gastrointestinal and Liver Specialists of Tidewater Pllc | Internal Medicine | 113 Gainsborough Square, Suite 101, Chesapeake, VA 23320-1713 | 2007-05-18 |
| 1942300298 | Tidewater Gastroenterology,pllc | Internal Medicine | 112 Gainsborough Sq, Suite 200, Chesapeake, VA 23320-1706 | 2006-09-25 |
| 1326028747 | Scott Lee Yagel | Internal Medicine | 113 Gainsborough Sq Ste 202, Chesapeake, VA 23320-1714 | 2006-01-20 |
| 1083691356 | Jeremy Peter Domanski | Internal Medicine | 112 Gainsborough Sq, Ste 200, Chesapeake, VA 23320-1706 | 2005-12-28 |
| 1124005830 | Felix P Tiongco | Internal Medicine | 112 Gainsborough Sq, Suite 200, Chesapeake, VA 23320-1706 | 2005-12-23 |
| Find all providers in CHESAPEAKE | ||||
| City | CHESAPEAKE |
| Zip Code | 23320 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.