DR. SUPAKUNYA EDMONSON


Address: Uss Enterprise, Medical Dept, Norfolk, VA 23551-0001
Phone: 7574448632

DR. SUPAKUNYA EDMONSON (NPI# 1366420853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366420853
Entity Type Individual
Full Name DR. SUPAKUNYA EDMONSON
Credential D.O.
Practice Address Uss Enterprise
Medical Dept
Norfolk
VA 23551-0001
Mailing Address 1714 Pompey St
Virginia Beach
VA 23464-6514
Practice Telephone 7574448632
Enumeration Date 2006-01-04
Last Update Date 2015-05-18
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine OS9620 FL Allopathic & Osteopathic Physicians
Y 2084N0400X Psychiatry & Neurology
Specialization: Neurology
0102201767 VA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
VA GROUP PTAN C06778 01

Office Location

Street Address USS ENTERPRISE
MEDICAL DEPT
City NORFOLK
State VA
Zip Code 23551-0001

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1407820426 Jeffery Wayne Paulson Family Medicine Fleet Forces Command, 1562 Mitscher Ave, Ste 250, Norfolk, VA 23551-0001 2006-02-15
1891775532 Martin Lewis Snyder Surgery U.S.fleet Forces Command-command Surgeon, 1562 Mitscher Ave Suite 250, Norfolk, VA 23551-0001 2006-01-19
1871585448 Tiffany A Jones Dental Hygienist Uss John F. Kennedy Cv-67, 1562 Mitscher Ave Suite 250, Norfolk, VA 23551-0001 2005-08-18
1831724061 Steven Mitchell Hartzler Physician Assistant 1775 Forrestal Dr Bldg 33, Norfolk, VA 23551-0001 2020-03-09
1194205716 Caleb Swain Student in an Organized Health Care Education/Training Program 1775 Forrestal Dr Bldg 33, Norfolk, VA 23551-0001 2018-08-14
1548757263 Dylan Griffiths Student in an Organized Health Care Education/Training Program 1775 Forrestal Dr, Norfolk, VA 23551-0001 2018-04-18
1184129629 Michael Uriah Hoerner Student in an Organized Health Care Education/Training Program Us Marine Corps Forces Command 1775 Forrestal Drive, Norfolk, VA 23551-0001 2018-03-27
1992208763 Philippe Andrew Warren Student in an Organized Health Care Education/Training Program 1775 Forrestal Dr Bldg 33, Norfolk, VA 23551-0001 2018-03-17
1780955534 Christopher Halagarda Dietitian, Registered Us Marine Corps Forces Command, 1775 Forrestal Drive, Norfolk, VA 23551-0001 2012-01-25
1750945333 Scott David Berkheimer Student in an Organized Health Care Education/Training Program 1775 Forrestal Dr Bldg 33, Norfolk, VA 23551-0004 2019-04-29
Find all providers in zip 23551

Taxonomy Information

Taxonomy Code 2084N0400X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Neurology

Taxonomy Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1811339237 Sahawat Tantikittichaikul Psychiatry & Neurology 301 N 27th St Ste 12, Norfolk, NE 68701 2013-07-26
1588607089 Susan Melinda Brown Psychiatry & Neurology 301 Riverview Ave Ste 202, Norfolk, VA 23510-1065 2006-06-13
1558793679 Raymond Gerard Troiano Psychiatry & Neurology 600 Gresham Dr, Suite 8630, Sentara Medical Group Neurology, Norfolk, VA 23507-1904 2013-07-31
1881983278 Bon Secours Depaul Medical Center Inc Psychiatry & Neurology 110 Kingsley Ln, Suite 411, Norfolk, VA 23505-4614 2011-04-06
1588806228 Sara Khorasani Psychiatry & Neurology 2700 W Norfolk Ave, Norfolk, NE 68701-4438 2009-03-26
1336393701 Ingrid Paola Loma-miller Psychiatry & Neurology 6161 Kempsville Cir, Suite 315, Norfolk, VA 23502-3932 2008-11-11
1982865135 Hua Wang Psychiatry & Neurology 600 Gresham Dr, Suite 8630, Norfolk, VA 23507-1904 2008-06-20
1932369980 Steven Thomas Kanarek Psychiatry & Neurology 6161 Kempsville Cir, Suite 315, Norfolk, VA 23502-3932 2008-06-12
1639361033 Carmen Roxana Fuentes Psychiatry & Neurology 6161 Kempsville Cir, Suite 315, Norfolk, VA 23502-3932 2007-08-10
1619043551 Neurology Consultants of Tidewater, Pllc Psychiatry & Neurology 6161 Kempsville Cir, Suite 315, Norfolk, VA 23502-3932 2006-11-24
Find all providers in NORFOLK

Competitor

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City NORFOLK
Zip Code 23551

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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