Individual
DR. MILY J. KANNARKAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
825 FAIRFAX AVE, SUITE 201, NORFOLK, VA 23507-1914
(757) 446-7040
(757) 446-7049
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-7040
(757) 446-7049
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
0101249801
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-022
TRICARE/CHAMPUS
VA
01
—
10077552
OPTIMA HEALTH
VA
01
—
1740405364
UNITED HEALTHCARE/MAMSI
VA
05
—
1740405364
—
VA
01
—
427872
ANTHEM BC/BS
VA
05
—
5917498
—
NC
01
—
PAR
AETNA
VA
Enumeration date
04/17/2007
Last updated
11/18/2011
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