Provider Demographics
NPI:1538216478
Name:DRZEWIECKI, ANNA E (MD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:E
Last Name:DRZEWIECKI
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 1:1856 COLONIAL MEDICAL CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3075
Mailing Address - Country:US
Mailing Address - Phone:757-481-4969
Mailing Address - Fax:757-481-9373
Practice Address - Street 1:1856 COLONIAL MEDICAL CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3075
Practice Address - Country:US
Practice Address - Phone:757-481-4969
Practice Address - Fax:757-481-9373
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049717208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA380509OtherANTHEM BCBS
VA54047OtherSENTARA OPTIMA
541858799OtherTRICARE
541858799OtherVIRGINIA HEALTH NETWORK
VA54047OtherSENTARA OPTIMA
541858799OtherTRICARE