Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 0101272661 | VA |
N | 207YP0228X | Pediatric Otolaryngology | 283493 | MA |
NPI | 1699160283 |
---|---|
Provider Name | Ariana Ghom Greenwell |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22903-2824 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2015 |
Last Update Date | 27/09/2021 |