Provider Demographics
NPI:1659347193
Name:AGEY, DAVID LAWRENCE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LAWRENCE
Last Name:AGEY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 TOMCAT BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23460-2188
Mailing Address - Country:US
Mailing Address - Phone:757-953-3848
Mailing Address - Fax:
Practice Address - Street 1:1550 TOMCAT BLVD STE 150
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23460-2188
Practice Address - Country:US
Practice Address - Phone:757-953-3848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110004909363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical