Provider Demographics
NPI:1477650679
Name:IVY SAVOY-WHITFIELD MD
Entity Type:Organization
Organization Name:IVY SAVOY-WHITFIELD MD
Other - Org Name:FAITH FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IVY
Authorized Official - Middle Name:V
Authorized Official - Last Name:SAVOY-WHITFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-410-3562
Mailing Address - Street 1:PO BOX 1331
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23327-1331
Mailing Address - Country:US
Mailing Address - Phone:757-410-3562
Mailing Address - Fax:757-410-3563
Practice Address - Street 1:1417 N BATTLEFIELD BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4516
Practice Address - Country:US
Practice Address - Phone:757-410-3562
Practice Address - Fax:757-410-3563
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IVY SAVOY-WHITFIELD MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-20
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
VA0101039911207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B59694Medicare UPIN
VAC08201Medicare ID - Type Unspecified