Basic Information
| Provider Information | |||||||||
| NPI: | 1336114628 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAGLAYA | ||||||||
| FirstName: | FERNANDO | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 816 INDEPENDENCE BLVD | ||||||||
| Address2: | STE 2H | ||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234556010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7573636850 | ||||||||
| FaxNumber: | 7578226226 | ||||||||
| Practice Location | |||||||||
| Address1: | 850 KEMPSVILLE RD | ||||||||
| Address2: | STE 100G | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235023920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7572615910 | ||||||||
| FaxNumber: | 7572610018 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2006 | ||||||||
| LastUpdateDate: | 02/25/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 0101231005 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RS0012X | 0101231005 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine |
ID Information
| ID | Type | State | Issuer | Description | 005860466 | 05 | VA | MEDICAID |