Provider Demographics
NPI:1922092691
Name:NAUMOVSKI, NIKOLCHE J (MD)
Entity Type:Individual
Prefix:DR
First Name:NIKOLCHE
Middle Name:J
Last Name:NAUMOVSKI
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 1:1000 COMMERCIAL LN
Mailing Address - Street 2:WESTERN TIDWATER COMMUNITY SERVICES BOARD
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8148
Mailing Address - Country:US
Mailing Address - Phone:757-942-1025
Mailing Address - Fax:757-925-2218
Practice Address - Street 1:1000 COMMERCIAL LN
Practice Address - Street 2:WESTERN TIDWATER COMMUNITY SERVICES BOARD
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8148
Practice Address - Country:US
Practice Address - Phone:757-942-1025
Practice Address - Fax:757-925-2218
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010484632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA244565OtherTRIGON BCBS/HEALTHKEEPERS
VA7106009Medicaid
VA7106025Medicaid
VA244565OtherTRIGON BCBS/HEALTHKEEPERS