Provider Demographics
NPI:1093733388
Name:HEDBERG, ANN ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:ELIZABETH
Last Name:HEDBERG
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:PO BOX 200
Mailing Address - Street 2:5525 CATAWBA HOSPITAL DRIVE
Mailing Address - City:CATAWBA
Mailing Address - State:VA
Mailing Address - Zip Code:24070-2115
Mailing Address - Country:US
Mailing Address - Phone:540-375-4268
Mailing Address - Fax:540-375-4394
Practice Address - Street 1:5525 CATAWBA HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:CATAWBA
Practice Address - State:VA
Practice Address - Zip Code:24070-2115
Practice Address - Country:US
Practice Address - Phone:540-375-4268
Practice Address - Fax:540-375-4394
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010492582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA248584OtherBCBS
VA00X173A01Medicare PIN
VAF79159Medicare UPIN
VA248584OtherBCBS