Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 0101056114 | VA |
NPI | 1053414433 |
---|---|
Provider Name | Dr. Theodore W Uroskie |
First Address | Norfolk, VA 23502-2964 |
Second Address | Norfolk, VA 23502-2964 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 13/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0016493775 | VA SALES TAX NUMBER (01) | |
006902090 | (05) | VA |
0101056114 | VA LICENSE (01) | VA |
278499 | BCBS (01) | |
295242 | BCBS (01) | VA |
295245 | BCBS (01) | VA |
3755 | ASPRS (01) | |
65573 | SENTARA (01) | |
7530450 | AETNA (01) | |
BU7390622 | DEA NUMBER (01) | |
C08782 | MEDICARE GROUP NUMBER (01) | |
H36682 | (02) | VA |
P00094977 | MEDICARE RAILROAD (01) |