Individual
MRS. MARY ANNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7240
(757) 668-7721
Mailing address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7240
(757) 668-7721
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110-005419
VA
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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