Provider Demographics
NPI:1477668200
Name:KNIGHT, HERBERT G (MD)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:G
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4460 CORPORATION LN
Mailing Address - Street 2:SUITE 190
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3150
Mailing Address - Country:US
Mailing Address - Phone:757-518-8823
Mailing Address - Fax:757-518-8832
Practice Address - Street 1:4460 CORPORATION LN
Practice Address - Street 2:SUITE 190
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3150
Practice Address - Country:US
Practice Address - Phone:757-518-8823
Practice Address - Fax:757-518-8832
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101047194207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08822Medicare PIN