Provider Demographics
NPI:1124317391
Name:SILVA-GATA, CHARMAINE GUBALLA (MD)
Entity type:Individual
Prefix:DR
First Name:CHARMAINE
Middle Name:GUBALLA
Last Name:SILVA-GATA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:825 FAIRFAX AVE STE 710
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1914
Mailing Address - Country:US
Mailing Address - Phone:757-446-5884
Mailing Address - Fax:757-446-5918
Practice Address - Street 1:1020 FIRST COLONIAL RD STE A
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3002
Practice Address - Country:US
Practice Address - Phone:757-395-1850
Practice Address - Fax:757-961-5622
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012579652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty