Individual
DR. SAMUEL M. MAHAFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7703
(757) 668-8860
Mailing address
CHILDRENS SURGICAL SPECIALTY GROUP, PO BOX 631617, BALTIMORE, MD 21263-1617
(757) 668-7703
(757) 668-8860
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
0101237610
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1702645
UNITED HEATLH CARE
VA
01
—
174614
ANTHEM BCBS
VA
01
—
2134227
MAMSI/OPTIMUM CHOICE
VA
01
—
3116108340002E
CIGNA
VA
01
—
8953736
NORTH CAROLINA MEDICAID
VA
01
—
92534
OPTIMA/SENTARA HEALTH
VA
Enumeration date
07/28/2006
Last updated
07/08/2007
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