Bullaboy, Charles A.

Bullaboy, Charles A. is an individual health care provider with primary practice located at 601 Childrens Ln , Norfolk VA 23507-1910. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Cardiology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatric Cardiology is his primary health care specialty. Bullaboy, Charles A. can be contacted via phone (757) 668-7213.

Contact Information

Primary practice address
601 Childrens Ln Norfolk VA 23507-1910
Phone: (757) 668-7213
Fax: (757) 668-8225
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 0101028010 Virginia
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101058010 Virginia

Profile Details

NPI number 1699724245
LBN Legal business name Bullaboy, Charles A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Nov 29th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699724245 NPPES
Virginia MEDICAID 006722296
Virginia MEDICAID 0197625000
Virginia MEDICAID 7905245
Virginia MEDICAID 0016948820001
Virginia MEDICAID 119541700

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