Organization
PRINCESS ANNE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMAR A BLANCO M.D. (SOLE PROPRIETOR/PEDIATRICIAN)
(757) 853-3838
Entity
Organization
Contact information
Practice address
5040 E PRINCESS ANNE RD STE A, NORFOLK, VA 23502-1733
(757) 853-3838
(757) 853-0940
Mailing address
5040 E PRINCESS ANNE RD STE A, NORFOLK, VA 23502-1733
(757) 853-3838
(757) 853-0940
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101222303
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006732305
—
VA
01
—
22917
OPTIMA HEALTH
—
01
—
284466
ANTHEM BLUE CROSS BLUE SHIELD
—
01
—
6732305
VA PREMIER
—
01
—
7543052
AETNA U.S. HEALTHCARE
—
Enumeration date
05/29/2008
Last updated
05/29/2008
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