Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 0101016545 | VA |
NPI | 1033140322 |
---|---|
Provider Name | Charles E Umstott |
First Address | Newport News, VA 23601-1318 |
Second Address | Newport News, VA 23601-1929 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 17/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033140322 | (05) | VA |
B09691 | (02) | VA |