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ADVANCED ALLERGY AND ASTHMA OF VIRGINIA

Allergy

Midlothian, Virginia

Provider NPI: 1104157114

Organization Information:
Organization Name:  ADVANCED ALLERGY AND ASTHMA OF VIRGINIA


Practice Location:
5924 HARBOUR PARK DR  MIDLOTHIAN, VA 23112 US
Tel: 804-739-9005  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207KA0200XPhysicians
Allergy & Immunology
Allergy
VA0101038621

Other Provider Identifiers:

IssuerNumberStateType
6000631VA05
ANTHEM029755VA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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