Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 0101266740 | VA |
N | 207RC0000X | Internist - Cardiovascular Disease | A65303 | CA |
NPI | 1013082163 |
---|---|
Provider Name | Dr. Sally G Tamayo |
First Address | Chesapeake, VA 23322-6909 |
Second Address | Portsmouth, VA 23708-2111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 09/08/2019 |