Healthcare Provider Details
I. General information
NPI: 1942735071
Provider Name (Legal Business Name): SILYA MAZIGH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/26/2017
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 J CLYDE MORRIS BLVD
NEWPORT NEWS VA
23601-1929
US
IV. Provider business mailing address
856 J CLYDE MORRIS BLVD STE A
NEWPORT NEWS VA
23601-1318
US
V. Phone/Fax
- Phone: 757-594-3580
- Fax:
- Phone: 757-316-5800
- Fax: 860-714-8275
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 0101269489 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: