Organization Name: | DOMINION HEALTH MEDICAL ASSOC |
NPI Number: | 1427306315 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CECIL F HAZELWOOD (MANAGER/SDHG) |
Mailing Address: | 2232 Wilborn Ave Suite F South Boston |
State: | VA US |
Postal Code: | 24592 |
Phone Number: | 4345178095 |
Fax Number: | 4345173887 |
NPI Enumeration Date: | 08/27/2012 |
NPI Last Update Date: | 02/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |