Healthcare Provider Details

I. General information

NPI: 1790128072
Provider Name (Legal Business Name): ANNA TRIKHACHEVA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2013
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 JOHN PAUL JONES CIR
PORTSMOUTH VA
23708-2111
US

IV. Provider business mailing address

8901 WISCONSIN AVE
BETHESDA MD
20889
US

V. Phone/Fax

Practice location:
  • Phone: 757-953-5008
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number01075083A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number01075083A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: