Guillermo G Mosquera, M.D.
Individual provider Active NPI Urology Physician · Virginia Beach, VA
NPI 1891775649 · NPPES record last updated Dec 11, 2012
Key facts
- NPI
- 1891775649
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Urology Physician 208800000X
- License
- 0101023643 (VA)
- Practice address
- 225 Clearfield Ave
Virginia Beach, VA 23462-1815 - Phone
- (757) 489-4111
- Fax
- (757) 452-3580
- NPI assigned
- Jan 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 0101023643 | VA | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urology of Virginia PC | Past | Accepting new patients | |
| Urology of Virginia, PC | Urology | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 0101023643 | VA | Yes |
Addresses
Primary practice location
225 Clearfield Ave
Virginia Beach, VA 23462-1815
Mailing address
225 Clearfield Ave
Virginia Beach, VA 23462-1815
Phone (757) 489-4111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15318 | Other | VA | SENTARA HEALTHCARE |
| 007501501 | Medicaid | VA | |
| 382485 | Other | VA | ANTHEM BC BS |
Other providers in Virginia Beach, VA
- Rachael Moskalski
- Jonina L Moskowitz
- Joelle Elaine Mosley
- Kimberly Mosley
- Nicole Christine Mosley
- Gary Blair Moss
- Monika Moss
- Sarah Mosteirin
- Walter A Mostek
- Thomas Wayne Mostiler
All providers in Virginia Beach, VA · Urology 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 11, 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.