Healthcare Provider Details
I. General information
NPI: 1841602729
Provider Name (Legal Business Name): ALICIA BARNES CHITANAND DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/27/2014
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1300 SENTARA PARK # 3
VIRGINIA BEACH VA
23464-5884
US
IV. Provider business mailing address
1440 W TAYLOR ST # 227
CHICAGO IL
60607-4623
US
V. Phone/Fax
- Phone: 757-252-3050
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | FC6870251 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | 0102204556 |
| License Number State | VA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | OS20381 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: