MEDICARE: DR. MARIA ALAVANJA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	0101238686	VA

General Provider Information

NPI Number	:	1184680233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA ALAVANJA MD

Provider Business Mailing Address
First Line	:	420 MIDDLE ST
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23704-2804
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	355 CRAWFORD ST STE 333
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23704-2819
Country	:	US
Telephone Number	:	757-255-8455
Fax Number	:	833-992-2462

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	05/20/2024

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