GASTROINTESTINAL AND LIVER SPECIALISTS OF TIDEWATER PLLC (NPI# 1891338745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891338745 |
| Entity Type | Organization |
| Organization Name | GASTROINTESTINAL AND LIVER SPECIALISTS OF TIDEWATER PLLC |
| Practice Address |
1101 First Colonial Rd Ste 400 Virginia Beach VA 23454-2409 |
| Practice Telephone | 7574814817 |
| Practice Fax Number | 7574817138 |
| Mailing Telephone | 7574814817 |
| Mailing Fax Number | 7574817138 |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2019-10-23 |
| Authorized Official Name | GLADYS ARLENE DAVIES (ADMINISTRATOR) |
| Authorized Official Telephone | 7574641644 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Gastroenterology, Ltd | Doing Business As Name - Organization |
| Gastroenterology, Ltd. | Doing Business As Name - Organization |
| 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 |
| 1265640726 | Gastrointestinal and Liver Specialists of Tidewater Pllc | Internal Medicine | 113 Gainsborough Square, Suite 101, Chesapeake, VA 23320-1713 | 2007-05-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | GASTROINTESTINAL AND LIVER SPECIALISTS OF TIDEWATER PLLC | 1925 Glenn Mitchell Drive Suite 102, Virginia Beach, Virginia 23456 |
| Street Address |
1101 FIRST COLONIAL RD STE 400 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23454-2409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356994263 | Agape Consulting | Behavioral Analyst | 1216 Garth Court, Virginia Beach, VA 23454 | 2019-07-19 |
| 1831650266 | Amelia Jo Crutsinger | Physician Assistant | 1644 Kepler Bnd, Virginia Beach, VA 23454 | 2019-03-28 |
| 1538639158 | Bay Psychiatric II Inc | Counselor | 923 First Colonial Rd Suite 1821, Virginia Beach, VA 23454 | 2018-11-26 |
| 1487151759 | Akanksha Mohan | Student in an Organized Health Care Education/Training Program | 100 Mannng Drive, Chapel Hill, Nc 27514, Chapel Hill, NC 23454 | 2018-04-12 |
| 1275038580 | Food Lion, LLC | Durable Medical Equipment & Medical Supplies | 1615 General Booth Blvd, Virginia Beach, VA 23454 | 2018-03-28 |
| 1346783164 | Tracy Chasse | Occupational Therapy Assistant | 1628 Old Donation Parkway, Virginia Beach, VA 23454 | 2016-11-28 |
| 1982066627 | Jennifer Mitchell | Speech-Language Pathologist | 2101 Agecroft Rd., Virginia Beach, VA 23454 | 2016-03-22 |
| 1659730562 | Rebecca Houvener | Psychologist | 1120 First Colonial Rd Ste 202, Virginia Beach, VA 23454 | 2016-02-19 |
| 1932581741 | Monica Jane Bailey | Nurse Practitioner | 2110 N Great Neck Rd, Virginia Beach, VA 23454 | 2015-06-29 |
| 1376930073 | Ashley A Burkholder | Family Medicine | 1024 First Colonial Rd Ste 104, Virginia Beach, VA 23454 | 2015-04-20 |
| Find all providers in zip 23454 | ||||
| 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 |
|---|---|---|---|---|
| 1962842583 | Patty Tian Wang | Internal Medicine | 1717 Will O'wisp Drive, Suite 200, Virginia Beach, VA 23454 | 2013-06-27 |
| 1225012966 | Keith Edward Berger | Internal Medicine | 1301 First Colonial Rd, Ste 201, Virginia Beach, VA 23454-2263 | 2005-12-06 |
| 1063410413 | Patricia L Raymond | Internal Medicine | 1925 Glenn Mitchell Dr, Ste 102, Virginia Beach, VA 23456-0170 | 2005-07-11 |
| 1053548826 | Caitlyn Molino Patrick | Internal Medicine | 1101 First Colonial Rd, Suite 400, Virginia Beach, VA 23454-2409 | 2009-06-18 |
| 1689841637 | George H Pop | Internal Medicine | 1101 First Colonial Rd, Suite 300, Virginia Beach, VA 23454-2409 | 2008-05-09 |
| 1336279884 | Samuel Yoselevitz | Internal Medicine | 1101 First Colonial Rd, Suite 400, Virginia Beach, VA 23454-2409 | 2007-03-06 |
| 1922041953 | Joseph Sumner Bell IIi | Internal Medicine | 1101 First Colonial Rd, Suite 300, Virginia Beach, VA 23454-2409 | 2006-06-14 |
| 1609819200 | James W Rawles | Internal Medicine | 1101 First Colonial Rd, Suite 300, Virginia Beach, VA 23454-2409 | 2006-06-13 |
| 1326080490 | David H Stockwell | Internal Medicine | 1101 First Colonial Rd, Suite 300, Virginia Beach, VA 23454-2409 | 2006-06-12 |
| 1124060298 | Jan A Janson | Internal Medicine | 1101 First Colonial Rd, Suite 300, Virginia Beach, VA 23454-2409 | 2006-06-12 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23454 |
Please comment or provide details below to improve the information on GASTROINTESTINAL AND LIVER SPECIALISTS OF TIDEWATER PLLC.
| 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.