Individual
DANIEL M ATIENZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2790 GODWIN BLVD STE 101, SUFFOLK, VA 23434-8151
(757) 539-0670
(757) 539-1062
Mailing address
6350 CENTER DR STE 200, NORFOLK, VA 23502-4107
(757) 213-5700
(757) 213-5701
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
0101054037
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005820197
—
VA
01
—
110183882
RAILROAD MEDICARE
VA
01
—
54530
OPTIMA
VA
Enumeration date
06/22/2005
Last updated
01/17/2019
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