Provider Demographics
NPI:1871554907
Name:ABELEDA, MARIA C (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:C
Last Name:ABELEDA
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 1:770 W RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-1046
Mailing Address - Country:US
Mailing Address - Phone:276-223-3200
Mailing Address - Fax:276-223-0617
Practice Address - Street 1:770 W RIDGE RD
Practice Address - Street 2:SUITE 220
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-1046
Practice Address - Country:US
Practice Address - Phone:276-223-3329
Practice Address - Fax:276-223-0478
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010469102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
260029949OtherMEDICARE RAILROAD
VAC04812OtherMEDICARE GROUP NUMBER
25449400OtherMAGELLAN
VA244611OtherANTHEM
VA168629OtherVALUE OPTIONS
VA004945298Medicaid
VA258140OtherANTHEM
VA258141OtherANTHEM
170432000OtherMAGELLAN
VA004945298Medicaid
VA258140OtherANTHEM
170432000OtherMAGELLAN