Provider Demographics
NPI:1134154826
Name:CUNDIFF, MARIA REEVES (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:REEVES
Last Name:CUNDIFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3679 HILL BREEZE RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4749
Mailing Address - Country:US
Mailing Address - Phone:757-486-2341
Mailing Address - Fax:
Practice Address - Street 1:3679 HILL BREEZE RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-4749
Practice Address - Country:US
Practice Address - Phone:757-486-2341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101033645207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1134154826Medicaid
VA220000543Medicare PIN
VA1134154826Medicaid