Healthcare Provider Details

I. General information

NPI: 1740784164
Provider Name (Legal Business Name): KAITLIN HUFSTETLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 FAIRFAX AVE
NORFOLK VA
23507-1914
US

IV. Provider business mailing address

2347 THOMAS RD NW
ATLANTA GA
30318-1146
US

V. Phone/Fax

Practice location:
  • Phone: 757-446-7979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101280902
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number93378
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: