Provider Demographics
NPI:1689223265
Name:DRS NEWMAN TAM AND ASSOC PC
Entity type:Organization
Organization Name:DRS NEWMAN TAM AND ASSOC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-427-9300
Mailing Address - Street 1:2236 GENERAL BOOTH BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-4092
Mailing Address - Country:US
Mailing Address - Phone:757-427-9300
Mailing Address - Fax:
Practice Address - Street 1:2236 GENERAL BOOTH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-4092
Practice Address - Country:US
Practice Address - Phone:757-427-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTIC DENTAL CARE PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-06
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty