TIDEWATER PHYSICIANS MULTISPECIALTY GROUP PC – NPI #1316790512
Clinic/Center

TIDEWATER PHYSICIANS MULTISPECIALTY GROUP PC is an AHC clinic located in WILLIAMSBURG, VA. NPPES has assigned the NPI number 1316790512 to TIDEWATER PHYSICIANS MULTISPECIALTY GROUP PC on April 08, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. This provider is also associated with 2 additional names listed below. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was last updated on Jun 11, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for TIDEWATER PHYSICIANS MULTISPECIALTY GROUP PC below.

NPI Profile for
TIDEWATER PHYSICIANS MULTISPECIALTY GROUP PC

NPI Number
1316790512
Enumeration Date

(more than 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
TIDEWATER PHYSICIANS MULTISPECIALTY GROUP PC
Other name(s)
All associated names:
Other Name
TPMG Newport News Procedure Suite
Other Name
TPMG-Williamsburg Procedure Suite
Primary location
5424 DISCOVERY PARK BOULEVARD BUILDING A, SUITE 101
BUILDING A, SUITE 101
WILLIAMSBURG, VA 23322
Phone: (757) 707-3505 Fax:
1 Other location(s):
860 Omni Blvd Ste 104
Newport News, VA 23606-4430
Phone: (757) 659-6285
Mailing address
860 OMNI BLVD STE 128
NEWPORT NEWS, VA 23606-4483
Phone: (757) 232-8769 Fax:
Organization Subpart
No
Authorized Official
CECILIA QUINTERO
CREDENTIALING MANAGER
Phone: (757) 964-8739
Updated
Certification Date
Jun 11, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.