Tidewater Skin Care and Pathology PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0101022994 Issued in VA

Legal business name

TIDEWATER SKIN CARE AND PATHOLOGY PC

Practice address

1157 First Colonial Rd
Suite 300
Virginia Beach, VA 23454-2432

Phone

(757) 333-8001

Fax

(757) 333-8002

NPI assigned

Feb 4, 2010

Last updated

Dec 20, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Padman A Menon, MDNPI 1164533386

Title

President

Phone

(757) 825-1846

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Padman A Menon, M.D.

  • Dermatology Physician
  • Virginia Beach, VA
  • NPI 1164533386
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292803200000",
    "number": "1215269097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 FIRST COLONIAL RD",
            "address_2": "SUITE 300",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542432",
            "telephone_number": "757-333-8001",
            "fax_number": "757-333-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 FIRST COLONIAL RD",
            "address_2": "SUITE 300",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542432",
            "telephone_number": "757-333-8001",
            "fax_number": "757-333-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER SKIN CARE AND PATHOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-04",
        "last_updated": "2010-12-20",
        "status": "A",
        "authorized_official_last_name": "MENON",
        "authorized_official_first_name": "PADMAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-825-1846",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101022994",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "200301017",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tidewater Physical Therapy, LLC
• Tidewater Podiatry Group
• Tidewater Psychotherapy Services
• Tidewater Psychotherapy Services
• Tidewater Rehabilitation Medicine
• Mercedes A. Tierney, M.S. CCC/SLP, M.S.ED
• Tiffany Foster Kessler, DDS (A Division of Atlantic Dental Care)
• Meghann G Tignor, CCC-SLP
• Anna Tihomirova, M.S.
• Sheria Dorisa Tilghmon

• Dermatology Physician in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.