Fenderson, Allen R.

Fenderson, Allen R. is an individual health care provider with primary practice located at 351 Edwin Dr Ste 102, Virginia Beach VA 23462-4559. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Fenderson, Allen R. can be contacted via phone (757) 499-5550.

Contact Information

Primary practice address
351 Edwin Dr Ste 102 Virginia Beach VA 23462-4559
Phone: (757) 499-5550
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101027355 Virginia

Profile Details

NPI number 1205832979
LBN Legal business name Fenderson, Allen R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Mar 30th, 2021 - about 3 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 1205832979 NPPES
Virginia MEDICAID 010014832
Virginia Other 462019
Virginia Other P00137845

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