Individual
DR. MARK E SHAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 GRESHAM DR, NORFOLK, VA 23507-1904
(757) 883-3483
(757) 627-0334
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 883-3483
(757) 627-0334
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
0101047236
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005818206
—
VA
01
—
0517L
BC/BS
NC
01
—
13834
SENTARA
VA
01
—
2125434
UHC/MAMSI
VA
01
—
394416
ANTHEM
VA
05
—
890517L
—
NC
01
—
PAR
AETNA
VA
Enumeration date
03/06/2006
Last updated
03/23/2009
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