Provider Demographics
NPI:1154384196
Name:SALVANT, KATHERINE LLOYD (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LLOYD
Last Name:SALVANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:PAGE
Other - Last Name:LLOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 KINGS WAY
Practice Address - Street 2:SUITE 3100
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2505
Practice Address - Country:US
Practice Address - Phone:757-345-5724
Practice Address - Fax:757-345-2236
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058008207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA830000168Medicare PIN
VA202114OtherCOVENTRY SOUTHERN HEALTH SERVICES
VA237395OtherANTHEM BCBS VA
VA830008295OtherRR MEDICARE
VAC06543OtherMEDICARE GROUP PTAN
VAC01120OtherMEDICARE GROUP PTAN
VA005869145Medicaid
VAVV7302AMedicare PIN