Individual
NORMA J MAXVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1250 E MARSHALL STREET, PEDIATRICS, RICHMOND, VA 23298-0510
(804) 828-3744
(804) 828-8559
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
0101249232
VA
2080P0203X
Pediatric Critical Care Medicine Physician
4301057500
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558407189
GROUP NPI
MI
01
—
350D176310
BCBSM GROUP #
MI
05
—
4532126
—
MI
Enumeration date
02/01/2006
Last updated
05/24/2011
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