Provider Demographics
NPI:1437454915
Name:HAROLD E CLOUD JR MD PC
Entity Type:Organization
Organization Name:HAROLD E CLOUD JR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:E
Authorized Official - Last Name:CLOUD
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:757-825-1500
Mailing Address - Street 1:2726 W MERCURY BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3100
Mailing Address - Country:US
Mailing Address - Phone:757-825-1500
Mailing Address - Fax:757-825-1699
Practice Address - Street 1:2726 W MERCURY BLVD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3100
Practice Address - Country:US
Practice Address - Phone:757-825-1500
Practice Address - Fax:757-825-1699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
080002395OtherMEDICARE
052875OtherBCBS
51006OtherSENTARA
VAA65218Medicare UPIN