| NPI | 1063516672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | P. FREDERICK DUCKWORTH Managing Physician 804-285-8206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 207RG0100X) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 363A00000X) |
| 363L00000X Nurse Practitioner (Licence: VA 363LS000X) | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2021-08-09 |