Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207VM0101X | Obstetrics & Gynecology | Maternal & Fetal Medicine | 0101036041 | VIRGINIA | No |
| 2 | 207VM0101X | Obstetrics & Gynecology | Maternal & Fetal Medicine | LT-3362 | NEW HAMPSHIRE | No |
| 3 | 207VM0101X | Obstetrics & Gynecology | Maternal & Fetal Medicine | 16513 | NEW HAMPSHIRE | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | PAR | OTHER | VIRGINIA | MULTIPLAN |
| 2 | PAR | OTHER | VIRGINIA | FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY |
| 3 | PAR | OTHER | VIRGINIA | CIGNA |
| 4 | 160017738 | MEDICARE PIN | VIRGINIA | |
| 5 | PAR | OTHER | VIRGINIA | VIRGINIA PREMIER HEALTH |
| 6 | 890554Y | MEDICAID | NORTH CAROLINA | |
| 7 | PAR | OTHER | VIRGINIA | VIRGINIA HEALTH NETWORK |
| 8 | 344433 | OTHER | VIRGINIA | ANTHEM - 601 COLLEY AVE |
| 9 | PAR | OTHER | VIRGINIA | TRICARE/CHAMPUS |
| 10 | 006280056 | MEDICAID | VIRGINIA | |
| 11 | 093663 | OTHER | VIRGINIA | ANTHEM BC BS |
| 12 | PAR | OTHER | VIRGINIA | CORVEL/CORCARE |
| 13 | 0554Y | OTHER | NORTH CAROLINA | NC BC BS |
| 14 | PAR | OTHER | VIRGINIA | USA MANAGED CARE |
| 15 | 14053 | OTHER | VIRGINIA | SENTARA OPTIMA |
| 16 | 227485 | OTHER | VIRGINIA | UHC/MAMSI |
| 17 | A54783 | MEDICARE UPIN | | |
| 18 | 160000784 | MEDICARE PIN | VIRGINIA | |
| 19 | PAR | OTHER | VIRGINIA | AETNA |
