Provider Demographics
NPI:1033325709
Name:SCHURSKY, MELVIN DENNIS JR (MD)
Entity Type:Individual
Prefix:
First Name:MELVIN
Middle Name:DENNIS
Last Name:SCHURSKY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7554 HOSPITAL DR
Practice Address - Street 2:STE 303
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-4178
Practice Address - Country:US
Practice Address - Phone:804-693-3400
Practice Address - Fax:804-693-9793
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245593208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00756837Medicare PIN
VA1033325709Medicaid
VA020916R53Medicare PIN