Provider Demographics
NPI:1326080557
Name:THURMAN, ANDREA R (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:R
Last Name:THURMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MICHELLE
Other - Last Name:RIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-7979
Mailing Address - Fax:757-446-5940
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-7979
Practice Address - Fax:757-446-5940
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052968207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5911313Medicaid
VAPAROtherMULTIPLAN
NC11313OtherBC/BS OF NC
VA1326080557Medicaid
VAPAROtherUNITED HEALTH CARE
VA367891OtherANTHEM BC/BC (825 FAIRFAX AVE.)
VA367900OtherANTHEM BC/BS (COLLEY AVE. AMB SURG)
VAPAROtherCORVEL/CORCARE
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA-010OtherTRICARE/CHAMPUS
PAROtherUSA MANAGED CARE
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherVA HEALTH NETWORK
VA10043044OtherSENTARA OPTIMA HEALTH
VA367893OtherANTHEM BC/BS (601 COLLEY AVE.)
VAPAROtherAETNA
VAPAROtherCIGNA
VA1326080557Medicaid