Provider Demographics
NPI:1467426627
Name:MANIAN, SWARNA (MD)
Entity Type:Individual
Prefix:
First Name:SWARNA
Middle Name:
Last Name:MANIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3241 WESTERN BRANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5260
Mailing Address - Country:US
Mailing Address - Phone:757-686-3508
Mailing Address - Fax:757-686-0541
Practice Address - Street 1:1168 FIRST COLONIAL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2426
Practice Address - Country:US
Practice Address - Phone:757-481-1113
Practice Address - Fax:757-496-3822
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101233323207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010172365Medicaid
VA541595397OtherTRICARE
VA541595397OtherMID ATLANTIC SOLUTIONS
VA96721OtherSENTARA/OPTIMA
VA181735OtherANTHEM
VA7214395OtherAETNA
007770B28Medicare PIN
VA7214395OtherAETNA