Provider Demographics
NPI:1720205172
Name:THE DOCTOR'S IN, PC
Entity Type:Organization
Organization Name:THE DOCTOR'S IN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:WERWATH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-428-1911
Mailing Address - Street 1:3198 PACIFIC AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-2949
Mailing Address - Country:US
Mailing Address - Phone:757-428-1911
Mailing Address - Fax:757-470-5977
Practice Address - Street 1:3198 PACIFIC AVE STE 104
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-2949
Practice Address - Country:US
Practice Address - Phone:757-428-1911
Practice Address - Fax:757-470-5977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034422207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA465954OtherANTHEM
VA391560304OtherTRICARE HEALTHNET
VA40935OtherSENTARA OPTIMA
VA010007640Medicaid
VAP00212156Medicare PIN
VA40935OtherSENTARA OPTIMA