Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 0101033864 | VA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 0101033864 | VA |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 20791 | MS |
N | 208G00000X | Cardiothoracic Vascular Surgeon | ME97567 | FL |
NPI | 1114009362 |
---|---|
Provider Name | Curtis G. Tribble |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22908-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E02471 | (02) | |
P01234013 | RAILROAD MEDICARE (01) | MS |