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Individual

DR. DEMETRIA YVETTE AUSTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2800 GODWIN BLVD, SUFFOLK, VA 23434-8038
(757) 967-8622
(757) 686-0541
Mailing address
3241 WESTERN BRANCH BLVD STE A, CHESAPEAKE, VA 23321-5260
(757) 686-3508
(757) 686-0541

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101254392
VA
207R00000X
Internal Medicine Physician
2003-00442
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2003-00442
LICENSE NUMBER
NC
05
89134CM
NC
05
N0044C
SC
01
P00033423
RAILROAD MEDICARE
NC
Enumeration date
09/13/2005
Last updated
03/07/2023
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