Provider Demographics
NPI:1972578920
Name:ROBICHAUD, MARIE R (MD)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:R
Last Name:ROBICHAUD
Suffix:
Gender:F
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:PO BOX 936
Mailing Address - Street 2:EVMS MEDICAL GROUP
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-5955
Mailing Address - Fax:757-446-5196
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:SUITE 118
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-5955
Practice Address - Fax:757-445-5196
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054423207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1972578920OtherCORVEL
VA1972578920Medicaid
NC1972578920Medicaid
VA1972578920OtherVIRGINIA HEALTH NETWORK
VA1972578920OtherAETNA
VA1972578920OtherUSA MANAGED CARE
VA1972578920OtherMULTIPLAN
VA1972578920OtherUNITED HEALTHCARE
VA1972578920OtherCOVENTRY NETWORK
VA1972578920OtherVIRGINIA PREMIER HEALTH PLAN
VA542311OtherANTHEM BC/BS
VA1972578920OtherCIGNA
VA1972578920OtherOPTIMA HEALTH
VA1972578920OtherTRICARE/CHAMPUS
VA542311OtherANTHEM BC/BS
VA1972578920OtherCORVEL
VA1972578920OtherVIRGINIA HEALTH NETWORK