Individual
KETI GVAZAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 GRESHAM DR, NORFOLK, VA 23507-1904
(757) 388-3000
Mailing address
PO BOX 1980, NORFOLK, VA 23501-1980
(757) 446-5600
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
0116041042
VA
Other
Enumeration date
08/13/2025
Last updated
08/13/2025
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