1568496768 NPI number — MRS. VALERIE A ADAIR PA

Table of content: MRS. VALERIE A ADAIR PA (NPI 1568496768)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568496768 NPI number — MRS. VALERIE A ADAIR PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADAIR
Provider First Name:
VALERIE
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568496768
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7068
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTSMOUTH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23707-0068
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-686-3508
Provider Business Mailing Address Fax Number:
757-686-0541

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3802 POPLAR HILL RD
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
CHESAPEAKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23321-5523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-467-4200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  0110001378 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 541141362 . This is a "TRICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com