Provider Demographics
NPI:1063529097
Name:WHIBLEY, THERESA W (MD)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:W
Last Name:WHIBLEY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:828 HEALTHY WAY
Mailing Address - Street 2:STE 330
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7959
Mailing Address - Country:US
Mailing Address - Phone:757-461-3890
Mailing Address - Fax:757-467-0301
Practice Address - Street 1:400 GRESHAM DR
Practice Address - Street 2:SUITE 811
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1901
Practice Address - Country:US
Practice Address - Phone:757-623-3845
Practice Address - Fax:757-623-0547
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2020-03-04
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Provider Licenses
StateLicense IDTaxonomies
VA0101040241207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB06801Medicare UPIN
VAC05065Medicare PIN