Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD452185 | PA |
Y | 2086X0206X | Surgical Oncologist | 0101266449 | VA |
NPI | 1114238458 |
---|---|
Provider Name | Charis A Venditti |
First Address | Fredericksburg, VA 22405-2585 |
Second Address | Fredericksburg, VA 22405-2585 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2010 |
Last Update Date | 24/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103092359 | (05) | PA |
1114238458 | (05) | VA |