Individual
DR. MARCUS STUART VANDIVIERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
436 HOSPITAL DR, WARRENTON, VA 20186-3026
(540) 347-1596
(540) 347-2936
Mailing address
9832 COBBLESTONE DR, WARRENTON, VA 20186-8617
(540) 347-2314
(540) 347-2396
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701001404
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056236
ANTHEM BLUE CROSS
VA
Enumeration date
03/27/2007
Last updated
07/08/2007
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