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Individual

SIOBHAN M. STATUTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
290 MASSIE RD, CHARLOTTESVILLE, VA 22903-1767
(434) 982-5450
(434) 982-5470
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101247305
VA
207QS0010X
Sports Medicine (Family Medicine) Physician
0101247305
VA

Other

Enumeration date
06/08/2007
Last updated
08/11/2023
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