Provider Demographics
NPI:1699001081
Name:FORT NORFOLK PLAZA MEDICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:FORT NORFOLK PLAZA MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:H
Authorized Official - Last Name:NEWBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-624-1785
Mailing Address - Street 1:301 RIVERVIEW AVENUE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1064
Mailing Address - Country:US
Mailing Address - Phone:757-624-1785
Mailing Address - Fax:757-624-1759
Practice Address - Street 1:301 RIVERVIEW AVENUE
Practice Address - Street 2:SUITE 500
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1064
Practice Address - Country:US
Practice Address - Phone:757-624-1785
Practice Address - Fax:757-624-1759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty