| NPI | 1861679953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN F SHIELDS Billing Agent 804-282-9133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101042472) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2008-04-20 |