Provider Demographics
NPI:1992989560
Name:PARKWAY FAMILY PRACTICE PC
Entity type:Organization
Organization Name:PARKWAY FAMILY PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FLORISA
Authorized Official - Middle Name:SABINIANO
Authorized Official - Last Name:SINGSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-497-9379
Mailing Address - Street 1:4551 PROFESSIONAL CIR STE 201
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-6442
Mailing Address - Country:US
Mailing Address - Phone:757-497-9379
Mailing Address - Fax:757-497-9379
Practice Address - Street 1:4551 PROFESSIONAL CIR STE 201
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6442
Practice Address - Country:US
Practice Address - Phone:757-497-9379
Practice Address - Fax:757-497-9379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051166261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC05904Medicare PIN