Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 0101225787 | VA |
NPI | 1063417764 |
---|---|
Provider Name | Dean S Mcgaughey III |
First Address | Norfolk, VA 23502-1871 |
Second Address | Norfolk, VA 23502-1871 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 22/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
005837634 | (05) | VA |
110202413 | RAILROAD MEDICARE (01) | VA |
26040 | OPTIMA (01) | VA |
H12224 | (02) | VA |