Provider Demographics
NPI:1326050402
Name:POSADAS, LUIS D (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:D
Last Name:POSADAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 MEDICAL DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-1765
Mailing Address - Country:US
Mailing Address - Phone:757-788-0092
Mailing Address - Fax:757-788-0969
Practice Address - Street 1:2244 EXECUTIVE DR
Practice Address - Street 2:SUTIE A
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2430
Practice Address - Country:US
Practice Address - Phone:757-315-3650
Practice Address - Fax:757-315-3651
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01010564142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACO3714Medicaid
VA7118406Medicaid
VA7118406Medicaid