| NPI | 1588149348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL CHAMBERS Manager Insurance Credentialing 540-536-0231 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease |
| 207LP2900X Anesthesiology Pain Medicine | |
| 2085R0202X Radiology Diagnostic Radiology | |
| 208600000X Surgery | |
| 2086S0129X Surgery Vascular Surgery | |
| 208800000X Urology | |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| 261QR0200X Clinic/Center Radiology | |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2025-03-31 |