Provider Demographics
NPI:1528013646
Name:SIMO, TODD EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:EDWARD
Last Name:SIMO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:312 2ND STREET
Mailing Address - Street 2:FIRST MED OF WILLIAMSBURG
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185
Mailing Address - Country:US
Mailing Address - Phone:757-229-4141
Mailing Address - Fax:757-229-1792
Practice Address - Street 1:312 2ND STREET
Practice Address - Street 2:FIRST MED OF WILLIAMSBURG
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185
Practice Address - Country:US
Practice Address - Phone:757-229-4141
Practice Address - Fax:757-229-1792
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0101051684VA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G86198Medicare UPIN