Provider Demographics
NPI:1912905852
Name:KAPLAN, IVOR BARRY (MD)
Entity type:Individual
Prefix:
First Name:IVOR
Middle Name:BARRY
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W BRAMBLETON AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1115
Mailing Address - Country:US
Mailing Address - Phone:757-627-6700
Mailing Address - Fax:757-627-8973
Practice Address - Street 1:400 W BRAMBLETON AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1115
Practice Address - Country:US
Practice Address - Phone:757-627-6700
Practice Address - Fax:757-627-8973
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040683208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010202205Medicaid
VA2133210OtherMAMSI
NC890688GMedicaid
VA15040OtherOPTIMA
VA1414231OtherCIGNA
VA178889OtherANTHEM
VAP00300125OtherRAILROAD MEDICARE
VA1414231OtherCIGNA
NC890688GMedicaid