Provider Demographics
NPI:1699063818
Name:FILE, MARY-VIRGINIA WEISSINGER (PA)
Entity type:Individual
Prefix:
First Name:MARY-VIRGINIA
Middle Name:WEISSINGER
Last Name:FILE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MARY-VIRGINIA
Other - Middle Name:WEISSINGER
Other - Last Name:SHANTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:844 KEMPSVILLE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3927
Mailing Address - Country:US
Mailing Address - Phone:757-261-0700
Mailing Address - Fax:
Practice Address - Street 1:844 KEMPSVILLE RD STE 204
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3927
Practice Address - Country:US
Practice Address - Phone:757-261-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110004921363A00000X
SC1954363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant