Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Immaculate Hospital LLC

Organization Surgery Physician · NPI 1205142791

Mary Immaculate Hospital LLC is a Surgery Physician in Newport News, Virginia. Registered with an NPI since 2010.

In the registry since
2010
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12720 McManus Blvd Ste 305
Newport News, VA 23602-4414
Phone: (757) 947-3170
Fax: (757) 947-3180
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X

Record details

NPI number1205142791
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMary Immaculate Hospital LLC
Authorized official Wilbur Gay — Cfo · (864) 561-7672
Other names Bon Secours Surgical Specialists; Bon Secours Surgical Specialists
NPI enumeratedAugust 23, 2010
Last updated in NPPESSeptember 21, 2020
Certification dateSeptember 21, 2020
Mailing address8580 Magellan Pkwy, Richmond, VA 23227-1149

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