Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 0101249683 | VA |
NPI | 1184738288 |
---|---|
Provider Name | Bridget Joseph |
First Address | Warrenton, VA 20186-2639 |
Second Address | Warrenton, VA 20186-2639 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 08/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0074854000 | (05) | WV |
1184738288 | (05) | VA |
F40137 | (02) |