Provider Demographics
NPI:1437344306
Name:TIDEWATER INTERNAL MEDICINE AND HYPERTENSION CENTER. PLC
Entity Type:Organization
Organization Name:TIDEWATER INTERNAL MEDICINE AND HYPERTENSION CENTER. PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIEMING
Authorized Official - Middle Name:
Authorized Official - Last Name:YAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-351-3400
Mailing Address - Street 1:1100 SMOKEY MOUNTAIN TRL STE 102
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-8147
Mailing Address - Country:US
Mailing Address - Phone:757-351-3400
Mailing Address - Fax:
Practice Address - Street 1:1100 SMOKEY MOUNTAIN TRL
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-8147
Practice Address - Country:US
Practice Address - Phone:757-351-3400
Practice Address - Fax:757-351-3400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty