Individual
MANUELA M DELACRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
160 KINGSLEY LN, SUITE 103, NORFOLK, VA 23505-4600
(757) 889-6677
(757) 889-6652
Mailing address
160 KINGSLEY LN, SUITE 103, NORFOLK, VA 23505-4600
(757) 889-6677
(757) 889-6652
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
0101042498
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15504
OPTIMA
VA
05
—
1679673685
—
VA
01
—
325099
ANTHEM
VA
01
—
415671
MDIPA
VA
01
—
4413117
AETNA
VA
05
—
5819199
—
VA
Enumeration date
09/22/2006
Last updated
04/24/2017
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