Provider Demographics
NPI:1174597223
Name:NAUMANN, DAN (MD)
Entity type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:NAUMANN
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 1:5000 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-9263
Mailing Address - Country:US
Mailing Address - Phone:804-822-4355
Mailing Address - Fax:
Practice Address - Street 1:2304 W MERCURY BLVD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3115
Practice Address - Country:US
Practice Address - Phone:757-951-1579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101045034207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010007801Medicaid
VA466635OtherANTHEM
VA4131824OtherAETNA
VA51025OtherSENTARA/OPTIMA
VA541595397OtherMID ATLANTIC SOLUTIONS
VA541595397OtherTRICARE
VAE44339Medicare UPIN
VA010007801Medicaid
VA541595397OtherVIRGINIA HEALTH NETWORK
VAE44339Medicare UPIN
VA010007801Medicaid