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1306617154
DEREK LAMONT COUSINS
NORFOLK, VA
NPI
1306617154
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: VA 0110010167)
Enumeration Date
2024-01-10
Last Update Date
2024-07-24
Business Address
Mr. DEREK LAMONT COUSINS PA-C
600 GRESHAM DR
NORFOLK, VA 23507-1904
Phone number: 757-466-0089
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Mailing Address
Mr. DEREK LAMONT COUSINS PA-C
6275 E VIRGINIA BEACH BLVD STE 300
NORFOLK, VA 23502-2851
Phone number: 757-466-0089
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