Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 0101039052 | VA |
NPI | 1043274251 |
---|---|
Provider Name | David F Trent |
First Address | Richmond, VA 23226-3781 |
Second Address | Richmond, VA 23230-1714 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 18/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
005824079 | (05) | VA |
237397 | ANTHEM BCBS VA (01) | VA |
830003331 | RR MEDICARE (01) | VA |
C01120 | MEDICARE GROUP PTAN (01) | VA |
C06543 | MEDICARE GROUP PTAN (01) | VA |