Provider Demographics
NPI:1659379170
Name:CATOLICO, MARIA ANGELA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ANGELA
Last Name:CATOLICO
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 1:6801 LUCY CORR CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-6657
Mailing Address - Country:US
Mailing Address - Phone:804-748-1227
Mailing Address - Fax:804-717-6659
Practice Address - Street 1:6801 LUCY CORR CT
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6657
Practice Address - Country:US
Practice Address - Phone:804-748-1227
Practice Address - Fax:804-717-6659
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA703532084P0800X
VA01012393162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010314305Medicaid
VA004945352Medicaid
260048281Medicare ID - Type UnspecifiedRAILROAD MEDICARE
H19812Medicare UPIN
VA010314305Medicaid