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Contact Information

STEPHANIE A MOODY ANTONIO, MD
600 GRESHAM DR
SUITE 1100
NORFOLK, VA23507-1904
 Phone: 757-388-6200
 Fax: 757-388-6201
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otology & Neurotology

207YX0901X 04 Physician/Otolaryngology
 

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for STEPHANIE A MOODY ANTONIO · (Female)

NPI Number 1366418956
Status Active
Credentials MD
Entity Individual
Enumeration date 02/24/2006
Last updated 01/26/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • VA License # 0101237385
  • NC Medicaid 89067RG
  • VA Medicaid 010118387
  • VA Medicaid 010170095
  • NC Other 067RG BC/BS
  • VA Other PAR AETNA
  • VA Other 172403 ANTHEM
  • VA Other 174750 ANTHEM
  • VA Other PAR CIGNA
  • VA Other PAR CORVEL/CORCARE
  • VA Other PAR FIRST HEALTH COMMERCIAL
  • VA Other PAR MULTIPLAN
  • VA Other 91377 SENTARA OPTIMA
  • VA Other -004 TRICARE/CHAMPUS
  • VA Other 2129791 UHC/MAMSI
  • VA Other PAR USA MANAGED CARE
  • VA Other PAR VA HEALTH NETWORK
  • VA Other PAR VA PREMIER HEALTH
Hospital affiliation(s)
  • SENTARA NORFOLK GENERAL HOSPITAL - (Acute Care)
    600 GRESHAM DR
    NORFOLK, VA 23507
  • SENTARA PRINCESS ANNE HOSPITAL - (Acute Care)
    2025 GLENN MITCHELL DRIVE
    VIRGINIA BEACH, VA 23456
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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