Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 0101051329 | VA |
NPI | 1346222080 |
---|---|
Provider Name | David A Phemister |
First Address | Lynchburg, VA 24502-4271 |
Second Address | Lynchburg, VA 24502-4271 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F88742 | (02) | VA |