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Individual

DR. MARIE J MANICKAVASAGAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
830 SOUTHAMPTON AVE, NORFOLK, VA 23510-1001
(757) 683-2889
(757) 683-2740
Mailing address
830 SOUTHAMPTON AVE, NORFOLK, VA 23510-1001
(757) 683-2889
(757) 683-2740

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101023631
VA

Other

Enumeration date
10/25/2006
Last updated
03/04/2008
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