| NPI | 1497817852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE SIDERIO Practice Manager 804-346-1507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 10107328) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 101016462) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101235462) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2008-03-05 |