Organization
LIV ADVANTIA DC PLLC
Active
Other names
Liv by Advantia Health
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA DODSON (CREDENTIALING MANAGER)
(443) 398-0189
Entity
Organization
Contact information
Practice address
1443 U ST NW, WASHINGTON, DC 20009-3974
(202) 315-5223
Mailing address
1443 U ST NW, WASHINGTON, DC 20009-3974
(202) 481-9205
(833) 629-0566
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
08/03/2020
Last updated
08/06/2024
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