Provider Demographics
NPI:1679591986
Name:LLOYD, SAMUEL J JR (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:J
Last Name:LLOYD
Suffix:JR
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 1:550 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:22186
Mailing Address - Country:US
Mailing Address - Phone:540-347-9450
Mailing Address - Fax:540-347-3126
Practice Address - Street 1:550 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:22186
Practice Address - Country:US
Practice Address - Phone:540-347-9450
Practice Address - Fax:540-347-3126
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101025875207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA001651OtherANTHEM
VA212137OtherMDIPA, MAMSI, ALLIANCE,
VA58150001OtherCAREFIRST
VA625515Medicaid
VAB05669Medicare UPIN
VA001651OtherANTHEM