Provider Demographics
NPI:1982670246
Name:VAZQUEZ, ANA H (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:H
Last Name:VAZQUEZ
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:757-446-5955
Mailing Address - Fax:757-446-5196
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:SUITE 118
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-5955
Practice Address - Fax:757-446-5196
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052047207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1982670246OtherFIRST HEALTH COMMERCIAL/COVENTRY HEALTH/SOUTHERN HEALTH
VAPAROtherUSA MANAGED CARE
VAPAROtherCIGNA
VAPAROtherAETNA
VAPAROtherMULTIPLAN
VAPAROtherCORVEL
VA-003OtherTRICARE/CHAMPUS
VA1982670246OtherAETNA
VA449710OtherANTHEM BC/BS
VA1982670246OtherVIRGINIA PREMIER HEALTH PLAN
VA1982670246OtherUNITED HEALTHCARE
VA1982670246Medicaid
VA11108OtherOPTIMA HEALTH
NC5919332Medicaid
VAPAROtherVIRGINIA HEALTH VIRGINIA
NC5919332Medicaid
VAPAROtherUSA MANAGED CARE
VA1982670246OtherAETNA