Provider Demographics
NPI:1821009713
Name:EASTERN VIRGINIA HAND CENTER
Entity Type:Organization
Organization Name:EASTERN VIRGINIA HAND CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:FREUND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-464-5441
Mailing Address - Street 1:816 INDEPENDENCE BLVD
Mailing Address - Street 2:SUITE 3 B
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-6010
Mailing Address - Country:US
Mailing Address - Phone:757-464-5441
Mailing Address - Fax:757-464-1911
Practice Address - Street 1:816 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 3 B
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6010
Practice Address - Country:US
Practice Address - Phone:757-464-5441
Practice Address - Fax:757-464-1911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA03911174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB09243Medicare UPIN