Provider Demographics
NPI:1891051009
Name:LITZ, VIRGINIA PAIGE (DO)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:PAIGE
Last Name:LITZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 STAUNTON DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-5604
Mailing Address - Country:US
Mailing Address - Phone:304-269-9510
Mailing Address - Fax:304-269-2032
Practice Address - Street 1:133 STAUNTON DR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-5604
Practice Address - Country:US
Practice Address - Phone:304-269-9510
Practice Address - Fax:304-269-2032
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV41242084P0800X
NC2017-005762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNCY531AMedicaid
NC1891051009Medicaid