| NPI | 1538316203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE NEVADA JOHNSON Credentialing Coordinator 540-536-0103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology |
| 207V00000X Obstetrics & Gynecology | |
| 207X00000X Orthopaedic Surgery | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma | |
| 208100000X Physical Medicine & Rehabilitation | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2086S0129X Surgery, Vascular Surgery | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 174400000X Specialist | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2019-12-03 |