Ernette Yvonne Benson-Foulk, MD
Individual provider Active NPI Pediatrics Physician · Norfolk, VA
NPI 1023071503 · NPPES record last updated Dec 10, 2012
Key facts
- NPI
- 1023071503
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 0101054489 (VA)
- Practice address
- 6345 Center Dr
Building 14
Norfolk, VA 23502-4105 - Phone
- (757) 461-4027
- Fax
- (757) 461-8821
- NPI assigned
- Apr 7, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101054489 | VA | MD | Pediatrics Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101054489 | VA | Yes |
Addresses
Primary practice location
6345 Center Dr
Building 14
Norfolk, VA 23502-4105
Mailing address
6345 Center Dr
Building 14
Norfolk, VA 23502-4105
Phone (757) 461-4027
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023071503 | Medicaid | VA |
Other providers in Norfolk, VA
- Daniel K Benner
- Amanda Marie Bennett
- Jonathan Tucker Bennett
- Michelle Bennett
- Makenzie Slone Bennington-Winslow
- Candace Benson
- Patricia W. Benson
- Rose Elisabeth Benson
- Ciara Bentley
- Raymond Louis Benza
All providers in Norfolk, VA · Pediatrics Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.