Provider Demographics
NPI:1609849330
Name:DE VECIANA, MARGARITA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARITA
Middle Name:
Last Name:DE VECIANA
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: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:757-446-7900
Mailing Address - Fax:757-624-2254
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-7900
Practice Address - Fax:757-624-2254
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA010105861207VM0101X
VA0101050861207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherVIRGINIA HEALTH NETWORK
VA227482OtherUHC/MAMSI
VAPAROtherMULTIPLAN
VAPAROtherAETNA
VAPAROtherCORVEL/CORCARE
VA-010OtherTRICARE/CHAMPUS
VA055049OtherANTHEM
VA14055OtherSENTARA OPTIMA
VAPAROtherCIGNA
VAPAROtherUSA MANAGED CARE
NC0635VOtherBC/BS
VA006202756Medicaid
NC890635VMedicaid
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA006202756Medicaid
VAPAROtherMULTIPLAN
VAPAROtherVIRGINIA HEALTH NETWORK