Provider Demographics
NPI:1275512824
Name:MAXFIELD, DONNA (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:MAXFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1901 S MAIN ST
Mailing Address - Street 2:STE 1
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-6628
Mailing Address - Country:US
Mailing Address - Phone:540-552-1120
Mailing Address - Fax:540-552-1134
Practice Address - Street 1:1901 S MAIN ST
Practice Address - Street 2:STE 1
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6628
Practice Address - Country:US
Practice Address - Phone:540-552-1120
Practice Address - Fax:540-552-1134
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101042126207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006304354Medicaid
VAP00277018OtherMEDICARE RAILROAD
B59686Medicare UPIN