Moody Antonio, Stephanie Ann
Moody Antonio, Stephanie Ann is an individual health care provider with primary practice located at 600 Gresham Dr Suite 1100, Norfolk VA 23507-1904. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Otology & Neurotology. Allopathic & Osteopathic Physicians / Otology & Neurotology is her primary health care specialty. Moody Antonio, Stephanie Ann can be contacted via phone (757) 388-6200.Contact Information
Primary practice address
600 Gresham Dr Suite 1100
Norfolk VA 23507-1904
Phone: (757) 388-6200
Fax: (757) 388-6201
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 0101237385 | Virginia |
| Allopathic & Osteopathic Physicians / Otology & Neurotology | 207YX0901X | 0101237385 | Virginia |
Profile Details
| NPI number | 1366418956 |
|---|---|
| LBN Legal business name | Moody Antonio, Stephanie Ann |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 24th, 2006 |
| Last updated | Jan 26th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366418956 | NPPES |
| Virginia | Other | 174750 | ANTHEM |
| Virginia | Other | PAR | ANTHEM |
| Virginia | Other | PAR | ANTHEM |
| Virginia | Other | PAR | ANTHEM |
| Virginia | Other | 067RG | ANTHEM |
| Virginia | Other | 172403 | ANTHEM |
| Virginia | Other | 91377 | ANTHEM |
| Virginia | Other | PAR | ANTHEM |
| Virginia | Other | PAR | ANTHEM |
| Virginia | Other | -004 | ANTHEM |
| Virginia | MEDICAID | 010170095 | ANTHEM |
| Virginia | Other | PAR | ANTHEM |
| Virginia | Other | PAR | ANTHEM |
| Virginia | MEDICAID | 010118387 | ANTHEM |
| Virginia | Other | 2129791 | ANTHEM |
| Virginia | Other | PAR | ANTHEM |
| Virginia | MEDICAID | 89067RG | ANTHEM |
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