Provider Demographics
NPI:1366476855
Name:POWELL, DRUSILLA SAUNDERS (MD)
Entity Type:Individual
Prefix:DR
First Name:DRUSILLA
Middle Name:SAUNDERS
Last Name:POWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:DRUSILLA
Other - Middle Name:EVELYN
Other - Last Name:SAUNDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 DISCOVERY DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3871
Mailing Address - Country:US
Mailing Address - Phone:757-668-2500
Mailing Address - Fax:757-668-2510
Practice Address - Street 1:500 DISCOVERY DR
Practice Address - Street 2:SUITE 302
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3871
Practice Address - Country:US
Practice Address - Phone:757-668-2500
Practice Address - Fax:757-668-2510
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042808208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA463533OtherANTHEM
VA006729967Medicaid
VA13025OtherOPTIMA
NC890568IMedicaid
VA13025OtherOPTIMA
VA370000532Medicare ID - Type Unspecified