Individual
DR. CAMILLE M. KANAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
825 FAIRFAX AVE, SUITE 310, NORFOLK, VA 23507-1914
(757) 446-7900
(757) 446-7464
Mailing address
PO BOX 936, EVMS MEDICAL GROUP, NORFOLK, VA 23501-0936
(757) 446-7900
(757) 446-7464
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101257264
VA
207VM0101X
Maternal & Fetal Medicine Physician
Primary
0101257264
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-010
TRICARE/CHAMPUS
VA
01
—
1396738365
MULTIPLAN
VA
05
—
1396738365
—
NC
05
—
1396738365
—
VA
01
—
531397
ANTHEM BC/BS
VA
01
—
PAR
CORVEL
VA
Enumeration date
08/25/2005
Last updated
02/12/2015
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