Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 0101237473 | VA |
NPI | 1649243031 |
---|---|
Provider Name | Kelly M Maples |
First Address | Norfolk, VA 23510 |
Second Address | Norfolk, VA 23510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 26/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010134986 | (05) | VA |
178379 | ANTHEM (01) | VA |
7692114 | CIGNA (01) | VA |
I26986 | (02) | VA |