Provider Demographics
NPI:1023023793
Name:ST. CLAIR, HARVEY SHELDON (MD)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:SHELDON
Last Name:ST. CLAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 741593
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1593
Mailing Address - Country:US
Mailing Address - Phone:757-668-8544
Mailing Address - Fax:757-668-6544
Practice Address - Street 1:171 KEMPSVILLE RD
Practice Address - Street 2:BUILDING A
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4700
Practice Address - Country:US
Practice Address - Phone:757-668-6550
Practice Address - Fax:757-668-6544
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101036643207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA023095C41OtherMEDICARE
VA09-00056OtherUHC
VA006406971OtherVIRIGNIA PREMIER
VA54956OtherMAMSI/OPTIMUM CHOICE
VA690543COtherNORTH CAROLINA MEDICAID
VA006406971Medicaid
VA15157OtherOPTIMA/SENTARA HEALTH
VA4004870OtherAETNA
NC615713OtherNC PPO
VA1023023793OtherTRICARE
VA253795OtherANTHEM BCBS
VA2559256006OtherCIGNA
VA1023023793OtherTRICARE