Provider Demographics
NPI:1174573703
Name:HAREWOOD, DIONNE N (MD)
Entity type:Individual
Prefix:
First Name:DIONNE
Middle Name:N
Last Name:HAREWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4012 RAINTREE RD
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-3741
Mailing Address - Country:US
Mailing Address - Phone:757-488-2223
Mailing Address - Fax:757-488-8398
Practice Address - Street 1:4012 RAINTREE RD
Practice Address - Street 2:SUITE 200A
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-3741
Practice Address - Country:US
Practice Address - Phone:757-488-2223
Practice Address - Fax:757-488-8398
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101053806208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006718132Medicaid
VA006718132Medicaid