Provider Demographics
NPI:1093211039
Name:NELSON, TOBY EISENBERG (MD)
Entity Type:Individual
Prefix:
First Name:TOBY
Middle Name:EISENBERG
Last Name:NELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TOBY
Other - Middle Name:GWEN
Other - Last Name:EISENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 CROSSWAYS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2895
Mailing Address - Country:US
Mailing Address - Phone:757-282-4085
Mailing Address - Fax:
Practice Address - Street 1:1600 CROSSWAYS BLVD STE A
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2895
Practice Address - Country:US
Practice Address - Phone:757-282-4085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-30
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101278840207R00000X, 207RE0101X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program