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

Tidewater Medical Clinic PC

Organization Internal Medicine Physician · NPI 1467579482

Tidewater Medical Clinic PC is an Internal Medicine Physician in Chesapeake, Virginia. Licensed in Virginia. Registered with an NPI since 2007.

Licensed in
VA
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

111 Coastal Way
Chesapeake, VA 23320-4603
Phone: (757) 549-9671
Fax: (757) 549-6802
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 0101055402 (VA)

Record details

NPI number1467579482
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Luis Carpio — President · (757) 549-9671
NPI enumeratedMarch 23, 2007
Last updated in NPPESAugust 22, 2020
Mailing address111 Coastal Way, Chesapeake, VA 23320-4603

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