| NPI | 1194004093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE WRIGHT Billing Supervisor 757-539-7824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101053967) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101053967) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101053967) | |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2012-08-29 |