Basic Information
| Provider Information | |||||||||
| NPI: | 1134746092 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEO | ||||||||
| FirstName: | MADEEHA | ||||||||
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| Credential: | MBBS, MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 608 FAIRFAX AVE APT A | ||||||||
| Address2: | |||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235072065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4752435858 | ||||||||
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| Practice Location | |||||||||
| Address1: | 825 FAIRFAX AVE STE 563 | ||||||||
| Address2: | |||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235071914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7574467934 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2020 | ||||||||
| LastUpdateDate: | 06/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0116034343 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.