Individual
LLOYD A SHABAZZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
355 CRAWFORD ST, STE 300, PORTSMOUTH, VA 23704-2819
(757) 396-6333
(757) 396-6367
Mailing address
355 CRAWFORD ST, STE 300, PORTSMOUTH, VA 23704-2819
(757) 396-6333
(757) 396-6367
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
0101058359
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13658
OPTIMA HEALTH PLAN
VA
01
—
261076
MAMSI/MDIPA
VA
01
—
264301
ANTHEM BCBS
VA
01
—
3600387
UNITED HEALTHCARE
VA
01
—
4493043
AETNA PPO/MC
VA
01
—
7905448
NC MEDICAID
NC
Enumeration date
06/13/2005
Last updated
01/10/2008
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