Provider Demographics
NPI:1053414433
Name:UROSKIE, THEODORE W (MD)
Entity type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:W
Last Name:UROSKIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6261 E VIRGINIA BEACH BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-2964
Mailing Address - Country:US
Mailing Address - Phone:757-466-1000
Mailing Address - Fax:757-466-7788
Practice Address - Street 1:6261 E VIRGINIA BEACH BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2964
Practice Address - Country:US
Practice Address - Phone:757-466-1000
Practice Address - Fax:757-466-7788
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010561142086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00094977OtherMEDICARE RAILROAD
65573OtherSENTARA
3755OtherASPRS
VA0101056114OtherVA LICENSE
VA295242OtherBCBS
7530450OtherAETNA
0016493775OtherVA SALES TAX NUMBER
VA295245OtherBCBS
VA006902090Medicaid
278499OtherBCBS
C08782OtherMEDICARE GROUP NUMBER
C08782OtherMEDICARE GROUP NUMBER
65573OtherSENTARA
278499OtherBCBS
65573OtherSENTARA
BU7390622OtherDEA NUMBER