| Convenient Care Of Tidewater | |
|
113 Gainsborough Sq Suite 103 Chesapeake VA 23320-1713 | |
| (757) 549-0222 | |
| Not Available |
| Full Name | Convenient Care Of Tidewater |
|---|---|
| Speciality | Family Medicine |
| Location | 113 Gainsborough Sq, Chesapeake, Virginia |
| Authorized Official Name and Position | Anthony A Morris (PRESIDENT) |
| Authorized Official Contact | 7575490222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Convenient Care Of Tidewater Po Box 2518 Chesapeake VA 23327-2518 Ph: (757) 549-0222 | Convenient Care Of Tidewater 113 Gainsborough Sq Suite 103 Chesapeake VA 23320-1713 Ph: (757) 549-0222 |
| NPI Number | 1013088186 |
|---|---|
| Provider Enumeration Date | 11/12/2006 |
| Last Update Date | 01/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013088186 | NPI | - | NPPES |
| 72637 | Other | VA | OPTIMA |
| 104078 | Other | VA | ANTHEM |
| 0004520572 | Other | VA | AETNA |
| 010041741 | Medicaid | VA | |
| MEDCO | Other | VA | 75063 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101050282 (Virginia) | Primary |
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