Provider Demographics
NPI:1568558625
Name:GROSS, VICTORIA L (MD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:GROSS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9816 MAYLAND DR
Mailing Address - Street 2:100
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1457
Mailing Address - Country:US
Mailing Address - Phone:804-282-8510
Mailing Address - Fax:804-285-5750
Practice Address - Street 1:9816 MAYLAND DR
Practice Address - Street 2:100
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1457
Practice Address - Country:US
Practice Address - Phone:804-282-8510
Practice Address - Fax:804-285-5750
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-02-06
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Provider Licenses
StateLicense IDTaxonomies
VA0101243534207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA070000459OtherMEDICARE
VA1568558625OtherUNITED HEALTHCARE
VA355555OtherANTHEM
VA885825OtherSOUTHERN HEALTH
VA3183614OtherAETNA
VA9186914OtherCIGNA
VA885825OtherSOUTHERN HEALTH