Individual
MRS. KATHERINE DALTON MIKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1522 INSURANCE LN, SUITE A, CHARLOTTESVILLE, VA 22911-7229
(434) 974-9600
(434) 296-1036
Mailing address
3067 DARBY RD, KESWICK, VA 22947-2720
(434) 984-8899
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101040389
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006725783
—
VA
01
—
010718
CIGNA
VA
01
—
12062400003
SOUTHERN HEALTH
VA
01
—
20028
VETRI
VA
01
—
267171
MAMSI/ALLIANCE
VA
01
—
333852
ANTHEM
VA
Enumeration date
12/21/2005
Last updated
09/29/2012
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