Healthcare Provider Details

I. General information

NPI: 1801827704
Provider Name (Legal Business Name): NORMA C YU MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 04/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 W RIVERSIDE ST
COVINGTON VA
24426-1219
US

IV. Provider business mailing address

322 W RIVERSIDE ST
COVINGTON VA
24426-1219
US

V. Phone/Fax

Practice location:
  • Phone: 540-962-9696
  • Fax: 540-962-9704
Mailing address:
  • Phone: 540-962-9696
  • Fax: 540-962-9704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number0101026046
License Number StateVA

VIII. Authorized Official

Name: NORMA CHING YU
Title or Position: MD
Credential: MD
Phone: 540-962-9696