Provider Demographics
NPI:1215030002
Name:MAURONER, NORMAN LEE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:LEE
Last Name:MAURONER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3028
Mailing Address - Country:US
Mailing Address - Phone:540-347-5512
Mailing Address - Fax:540-341-4646
Practice Address - Street 1:555 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3028
Practice Address - Country:US
Practice Address - Phone:540-347-5512
Practice Address - Fax:540-341-4646
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101033227207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA80735OtherSOUTHERN HEALTH PROVIDER
VA486107OtherAETNA PROVIDER #
VA7093597OtherCIGNA PROVIDER #
VA274676OtherANTHEM BCBS PROVIDER #
VA6096417Medicaid
VA828917OtherMAMSI PROVIDER #
DC5082-0001OtherCAREFIRST BCBS PROVIDER #
VA7093597OtherCIGNA PROVIDER #
DC5082-0001OtherCAREFIRST BCBS PROVIDER #
VA828917OtherMAMSI PROVIDER #