Provider Demographics
NPI:1013179241
Name:CHAVARRIA, JUDIT MARIA (MD)
Entity Type:Individual
Prefix:
First Name:JUDIT
Middle Name:MARIA
Last Name:CHAVARRIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 GLENN MITCHELL DR STE 310
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-0019
Mailing Address - Country:US
Mailing Address - Phone:757-507-0255
Mailing Address - Fax:757-275-9880
Practice Address - Street 1:1950 GLENN MITCHELL DR STE 310
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-0019
Practice Address - Country:US
Practice Address - Phone:757-507-0255
Practice Address - Fax:757-275-9880
Is Sole Proprietor?:No
Enumeration Date:2008-06-29
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN53871208000000X
VA0101275647208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics