Individual
KIM MARIE PANZARELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
280 CHARLES H DIMMOCK PKWY STE 4, COLONIAL HEIGHTS, VA 23834-2940
(804) 549-4030
(804) 549-4032
Mailing address
7201 GLEN FOREST DR STE 100, RICHMOND, VA 23226-3759
(804) 549-4030
(804) 549-4032
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101231763
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005902096
—
VA
01
—
0300462
UNITED HEALTHCARE
—
01
—
070016578
RAILROAD MEDICARE
—
01
—
150946
SOUTHERN HEALTH
—
01
—
2906423
AETNA
—
01
—
384358
ANTHEM
—
Enumeration date
07/28/2005
Last updated
07/08/2025
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