Grenga, Tad Edward

Grenga, Tad Edward is an sole proprietor health care provider with primary practice located at 5818 Harbour View Blvd Suite 220, Suffolk VA 23435-3315. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Grenga, Tad Edward can be contacted via phone (757) 673-5900.

Contact Information

Primary practice address
5818 Harbour View Blvd Suite 220 Suffolk VA 23435-3315
Phone: (757) 673-5900
Fax: (757) 673-5905
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 0101041085 Virginia

Profile Details

NPI number 1124009253
LBN Legal business name Grenga, Tad Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 7th, 2005
Last updated Jan 6th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124009253 NPPES
Virginia MEDICAID 006901395
Virginia Other 118152
Virginia Other 410829
Virginia Other 15906

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