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Individual
VIRGINIA LOGUE MENENDEZ
Active
Individual
VIRGINIA LOGUE MENENDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
31452
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051133341
BLUE SHIELD PROVIDER NUMBER
AL
05
—
150423
—
AL
01
—
31452
STATE LICENSE NUMBER
AL
Enumeration date
05/12/2010
Last updated
11/02/2017
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