Provider Demographics
NPI:1508906306
Name:VIRGINIA HEMATOLOGY ONCOLOGY PLLC
Entity Type:Organization
Organization Name:VIRGINIA HEMATOLOGY ONCOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:POULIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-466-1800
Mailing Address - Street 1:5741 CLEVELAND ST
Mailing Address - Street 2:STE 300
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1751
Mailing Address - Country:US
Mailing Address - Phone:757-466-1800
Mailing Address - Fax:757-466-2790
Practice Address - Street 1:5741 CLEVELAND ST
Practice Address - Street 2:STE 300
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1751
Practice Address - Country:US
Practice Address - Phone:757-466-1800
Practice Address - Fax:757-466-2790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054787207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty