Provider Demographics
NPI:1841259728
Name:DE GUZMAN, MARIA R (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:R
Last Name:DE GUZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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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:757-446-5915
Mailing Address - Fax:757-446-5969
Practice Address - Street 1:721 FAIRFAX AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-2007
Practice Address - Country:US
Practice Address - Phone:757-446-5915
Practice Address - Fax:757-446-5969
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101058948208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherMULTIPLAN
VA285680OtherUHC/MAMSI
VA382815OtherANTHEM
VA-017OtherTRICARE/CHAMPUS
VAPAROtherAETNA
VAPAROtherCORVEL/CORCARE
VA006800564Medicaid
NC89063X4Medicaid
VAPAROtherCIGNA
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA10007081OtherSENTARA DAY REHAB
VAPAROtherUSA MANAGED CARE
NC063X4OtherBC/BS
VA29798OtherSENTARA OPTIMA
VAPAROtherVIRGINIA HEALTH NETWORK
VA10007081OtherSENTARA DAY REHAB
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA285680OtherUHC/MAMSI