1366490328 NPI number — PAUL EVANS SAVAS MD

Table of content: DR. TED COHEN DPM (NPI 1154320471)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366490328 NPI number — PAUL EVANS SAVAS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAVAS
Provider First Name:
PAUL
Provider Middle Name:
EVANS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366490328
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4000 COLISEUM DR
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
HAMPTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23666
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-827-2480
Provider Business Mailing Address Fax Number:
757-827-2566

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5208 MONTICELLO AVE
Provider Second Line Business Practice Location Address:
SUITE 180
Provider Business Practice Location Address City Name:
WILLIAMSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23188
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-645-3929
Provider Business Practice Location Address Fax Number:
757-827-2566
Provider Enumeration Date:
05/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  0101057603 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 284385 . This is a "ANTHEM BC/BS-WMSBRG" identifier , issued by the state of ( VI ) . This identifiers is of the category "OTHER".
  • Identifier: 8959665 . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 284386 . This is a "ANTHEM BC/BS-RICHMOND" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 006407595 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 901395 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 113077 . This is a "SOUTHERN HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 21971 . This is a "SENTARA/OPTIMA HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 273153 . This is a "MDIPA,MAMSI,OPTIMUM CHOIC" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 7065030 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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