Provider Demographics
NPI:1497849129
Name:LORICA, VICTOR EMMANUEL G (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:EMMANUEL G
Last Name:LORICA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 WALNUT STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4738
Mailing Address - Country:US
Mailing Address - Phone:703-246-9246
Mailing Address - Fax:703-246-9257
Practice Address - Street 1:3930 WALNUT STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4738
Practice Address - Country:US
Practice Address - Phone:703-246-9246
Practice Address - Fax:703-246-9257
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051945207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010137578Medicaid
VA010138159Medicaid
VA010138400Medicaid
VA010138302Medicaid
VA010137624Medicaid
VA005805724Medicaid
VA010138108Medicaid
VA010138299Medicaid
VA010138370Medicaid
VA010138132Medicaid
9073133OtherCIGNA
VA010137446Medicaid
VA010138086Medicaid
2062979OtherUNITED HEALTHCARE
47430003OtherCAREFIRST
VA010137527Medicaid
VA010138329Medicaid
VA010138400Medicaid
VA005805724Medicaid