Individual
NINA BALANCHIVADZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6251 E VIRGINIA BEACH BLVD STE 200, NORFOLK, VA 23502-2800
(757) 466-8683
Mailing address
6350 CENTER DR STE 200, NORFOLK, VA 23502-4107
(757) 905-5558
(757) 213-5762
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36560
SC
207R00000X
Internal Medicine Physician
4301117273
MI
207RH0003X
Hematology & Oncology Physician
Primary
0101274592
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/20/2011
Last updated
12/09/2024
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