Provider Demographics
NPI:1578539920
Name:OEHNINGER, SERGIO CARLOS (MD)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:CARLOS
Last Name:OEHNINGER
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:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-7100
Mailing Address - Fax:757-446-7455
Practice Address - Street 1:601 COLLEY AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1627
Practice Address - Country:US
Practice Address - Phone:757-446-7100
Practice Address - Fax:757-446-7455
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101041491207V00000X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherAETNA
NC890691XMedicaid
VAPAROtherUSA MANAGED CARE
VA-012OtherTRICARE/CHAMPUS
315256OtherUHC/MAMSI
VA52867OtherSENTARA OPTIMA
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherMULTIPLAN
VA006214975Medicaid
NC0691XOtherNC BC/BS
VAPAROtherCORVEL/CORCARE
VA081881OtherANTHEM
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VAPAROtherCIGNA
VAPAROtherCIGNA
NC0691XOtherNC BC/BS
VAE11837Medicare UPIN