Provider Demographics
NPI:1043706534
Name:REMSBERG, VICTORIA RENEE
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:RENEE
Last Name:REMSBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:RENEE
Other - Last Name:TABLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4810 AMESBURY WAY
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:MD
Mailing Address - Zip Code:21755-8100
Mailing Address - Country:US
Mailing Address - Phone:301-514-5518
Mailing Address - Fax:
Practice Address - Street 1:4810 AMESBURY WAY
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:MD
Practice Address - Zip Code:21755-8100
Practice Address - Country:US
Practice Address - Phone:304-514-5518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-08
Last Update Date:2018-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVF485387347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle