Provider Demographics
NPI:1144403262
Name:KIRVEN ORTHOPEDIC GROUP, P.C.
Entity Type:Organization
Organization Name:KIRVEN ORTHOPEDIC GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:MOSES
Authorized Official - Last Name:KIRVEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-963-6507
Mailing Address - Street 1:5701 CLEVELAND STREET, SUITE 600
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462
Mailing Address - Country:US
Mailing Address - Phone:757-963-6507
Mailing Address - Fax:757-963-6375
Practice Address - Street 1:5701 CLEVELAND STREET, SUITE 600
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462
Practice Address - Country:US
Practice Address - Phone:757-963-6507
Practice Address - Fax:757-963-6375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054245207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010208874Medicaid
VA179191OtherANTHEM
VA45172OtherOPTIMA
VA45172OtherSENTARA
VA010208874Medicaid