Provider Demographics
NPI:1548212079
Name:GUINS, THERESA E (MD)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:E
Last Name:GUINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 CONCERT DR STE 102
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-8082
Mailing Address - Country:US
Mailing Address - Phone:757-668-4933
Mailing Address - Fax:757-668-4947
Practice Address - Street 1:3960 VIRGINIA BEACH BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-2449
Practice Address - Country:US
Practice Address - Phone:757-668-4649
Practice Address - Fax:757-668-4644
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052583208000000X, 2080P0204X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016510250001Medicaid
VA006721893Medicaid
WV2002462000Medicaid
MD220531900Medicaid
NC7905361Medicaid
DE1000015893Medicaid
MD220531900Medicaid
WV2002462000Medicaid