Provider Demographics
NPI:1497937437
Name:SEVERINSKY, VALENTINA A (MD)
Entity Type:Individual
Prefix:DR
First Name:VALENTINA
Middle Name:A
Last Name:SEVERINSKY
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 1:4707 FOXHALL CRES NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-1064
Mailing Address - Country:US
Mailing Address - Phone:202-338-0077
Mailing Address - Fax:202-338-0018
Practice Address - Street 1:4707 FOXHALL CRES NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-1064
Practice Address - Country:US
Practice Address - Phone:202-338-0077
Practice Address - Fax:202-338-0018
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-01
Last Update Date:2007-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD16142207R00000X
MDD0035431207R00000X
VA0101042281207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F12240Medicare UPIN