Provider Demographics
NPI:1083670996
Name:AMMONS-KING, VALERIA (MD)
Entity Type:Individual
Prefix:
First Name:VALERIA
Middle Name:
Last Name:AMMONS-KING
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 1:301 RIVERVIEW AVE
Mailing Address - Street 2:SUITE 525
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1065
Mailing Address - Country:US
Mailing Address - Phone:757-227-6866
Mailing Address - Fax:757-277-0298
Practice Address - Street 1:301 RIVERVIEW AVENUE
Practice Address - Street 2:SUITE 525
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1064
Practice Address - Country:US
Practice Address - Phone:757-227-6866
Practice Address - Fax:757-277-0298
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052531207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF06195Medicare UPIN
VA003893P95Medicare PIN