Provider Demographics
NPI:1487663407
Name:VIRTUDES, LORETO P (MD)
Entity Type:Individual
Prefix:
First Name:LORETO
Middle Name:P
Last Name:VIRTUDES
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 1:3783 FETTLER PARK DR
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025-1946
Mailing Address - Country:US
Mailing Address - Phone:703-441-1276
Mailing Address - Fax:703-441-0097
Practice Address - Street 1:3783 FETTLER PARK DR
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025-1946
Practice Address - Country:US
Practice Address - Phone:703-441-1276
Practice Address - Fax:703-441-0097
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101045677207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
210772OtherANTHEM BCBS
090227OtherANTHEM HEALTHKEEPER
1021764OtherCIGNA
VA474704OtherAETNA
817893OtherALLIANCE
1383508OtherFIRST HEALTH
VA607666Medicaid
VA210772OtherBCBS
A0660001OtherCAREFIRST BCBS
A0660001OtherCAREFIRST BLUECHOICE
10719011OtherUNITED HEALTHCARE
299294OtherGREATWEST
817893OtherMDIPA
817893OtherALLIANCE
090227OtherANTHEM HEALTHKEEPER