Retina Group Of Tidewater Pc

LBN: Retina Group Of Tidewater Pc
Retina Group Of Tidewater Pc is an health care organization with primary practice located at 400 Gresham Dr Ste 308 , Norfolk VA 23507-1901. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as the primary health care specialty. Retina Group Of Tidewater Pc can be contacted via phone (757) 622-7000, or through Reddy, Venkat Manoranjan via phone (757) 622-7000.

Contact Information

Primary practice address
400 Gresham Dr Ste 308 Norfolk VA 23507-1901
Phone: (757) 622-7000
Fax: (757) 623-6708
Website:
Map and Directions
Authorized official contact:
Name: Reddy, Venkat Manoranjan Doctor of Medicine (MD)
Phone: (757) 622-7000

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 0101051339 Virginia

Profile Details

NPI number 1629256441
LBN Legal business name Retina Group Of Tidewater Pc
DBA Doing business as
Authorized official Reddy, Venkat Manoranjan Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 4th, 2008
Last updated Dec 8th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629256441 NPPES
Virginia MEDICAID 6303251

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