Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Tidewater Skin Care and Pathology PC

Organization Dermatology Physician · NPI 1215269097

Tidewater Skin Care and Pathology PC provides Dermatology Physician services in Virginia Beach, Virginia. Licensed in North Carolina and Virginia. Registered with an NPI since 2010.

Licensed in
NC, VA
In the registry since
2010
Specialties on file
2
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

1157 First Colonial Rd Ste 300
Virginia Beach, VA 23454-2432 Not confirmed with CMS for 15 years — call before visiting
Phone: (757) 333-8001
Fax: (757) 333-8002
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 0101022994 (VA)
Dermatology Physician Taxonomy 207N00000X · Licence 200301017 (NC)

Record details

NPI number1215269097
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Padman Menon — President · (757) 825-1846
NPI enumeratedFebruary 4, 2010
Last updated in NPPESDecember 20, 2010
Mailing address1157 First Colonial Rd, Suite 300, Virginia Beach, VA 23454-2432

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