Provider Demographics
NPI:1699912931
Name:MANUEL GALDOS MD LTD
Entity type:Organization
Organization Name:MANUEL GALDOS MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GALDOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-826-5900
Mailing Address - Street 1:321 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-3814
Mailing Address - Country:US
Mailing Address - Phone:757-826-5900
Mailing Address - Fax:757-826-1386
Practice Address - Street 1:321 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-3814
Practice Address - Country:US
Practice Address - Phone:757-826-5900
Practice Address - Fax:757-826-1386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101024889207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6270115Medicaid