Provider Demographics
NPI:1134358138
Name:ABBOTT, LONIA FAITH (MD)
Entity type:Individual
Prefix:DR
First Name:LONIA
Middle Name:FAITH
Last Name:ABBOTT
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Gender:F
Credentials:MD
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Mailing Address - Street 1:436 CLAIRMONT CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-1765
Mailing Address - Country:US
Mailing Address - Phone:804-526-2121
Mailing Address - Fax:804-520-2617
Practice Address - Street 1:436 CLAIRMONT CT
Practice Address - Street 2:SUITE 100
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-1765
Practice Address - Country:US
Practice Address - Phone:804-526-2121
Practice Address - Fax:804-520-2617
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2015-04-01
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Provider Licenses
StateLicense IDTaxonomies
VA0101253891207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1134358138Medicaid
VA1134358138Medicare NSC