Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 0101054160 | VA |
NPI | 1003812082 |
---|---|
Provider Name | Dr. Beth M Winke |
First Address | Chesapeake, VA 23320-0745 |
Second Address | Chesapeake, VA 23320-0745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 17/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006800424 | (05) | VA |
E63489 | (02) | VA |