Tidewater Heart Laboratories

NPI #1164613543 in Hampton, Virginia

Provider Information

NPI Number: 1164613543
Entity Type: Organization
Organization Name: Tidewater Heart Laboratories
Subpart: Yes (part of a larger organization)
Parent Organization: TIDEWATER HEART INSTITUTE
Primary Specialty: Specialist
Enumeration Date: Aug 9, 2007
Last Updated: Aug 9, 2007

Practice Location

Address: 2116 EXECUTIVE DR
City: Hampton
State: Virginia
ZIP Code: 23666-2402
Phone: (757) 224-4233

Authorized Official

Name: MRS. BONNIE HERRING
Title: OFFICE ADMINISTATOR
Phone: (757) 825-4260

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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