Provider Demographics
NPI:1568627834
Name:PULMONARY MEDICINE OF VIRGINIA BEACH, INC.
Entity Type:Organization
Organization Name:PULMONARY MEDICINE OF VIRGINIA BEACH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:POPLAWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-481-2515
Mailing Address - Street 1:1008 FIRST COLONIAL RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3071
Mailing Address - Country:US
Mailing Address - Phone:757-481-2515
Mailing Address - Fax:757-481-4064
Practice Address - Street 1:1008 FIRST COLONIAL RD
Practice Address - Street 2:SUITE 103
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3071
Practice Address - Country:US
Practice Address - Phone:757-481-2515
Practice Address - Fax:757-481-4064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10639Medicare PIN