Provider Demographics
NPI:1174917082
Name:SIMCOE, RAEANNA POPLUS (MD)
Entity type:Individual
Prefix:
First Name:RAEANNA
Middle Name:POPLUS
Last Name:SIMCOE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RAEANNA
Other - Middle Name:LEE
Other - Last Name:POPLUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-332-5168
Mailing Address - Fax:540-332-5875
Practice Address - Street 1:201 LEW DEWITT BLVD STE A
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-1663
Practice Address - Country:US
Practice Address - Phone:540-245-7940
Practice Address - Fax:540-245-7941
Is Sole Proprietor?:No
Enumeration Date:2015-03-28
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101274465207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty