Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 0401411233 | VA |
NPI | 1003886912 |
---|---|
Provider Name | Dr. Albert W Parulis JR. |
First Address | Roanoke, VA 24019 |
Second Address | Roanoke, VA 24019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 09/09/2021 |