Bluestone Physician Services Southeast LLC

NPI #1255945739 in Norfolk, Virginia

Provider Information

NPI Number: 1255945739
Entity Type: Organization
Organization Name: Bluestone Physician Services Southeast LLC
Primary Specialty: Family Medicine
Enumeration Date: Sep 2, 2020
Last Updated: Oct 22, 2020

Practice Location

Address: 999 WATERSIDE DR STE 2525
City: Norfolk
State: Virginia
ZIP Code: 23510-3316
Phone: (757) 777-3433

Authorized Official

Name: TIM KOEHLER
Title: COO
Phone: (651) 342-1039

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X
Family Medicine	207Q00000X	Primary

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