Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 0101235677 | VA |
N | 208600000X | Surgeon | 0101235677 | VA |
N | 2086S0127X | Trauma Surgeon | 0101235677 | VA |
N | 2086X0206X | Surgical Oncologist | 0101235677 | VA |
NPI | 1164484283 |
---|---|
Provider Name | Dr. Clifford Lanier Deal III |
First Address | Midlothian, VA 23113-6003 |
Second Address | Richmond, VA 23229-4601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 08/07/2007 |