Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 0101258461 | VA |
N | 208600000X | Surgeon | 0101258461 | VA |
Y | 2086S0102X | Surgical Critical Care | 0101258461 | VA |
NPI | 1184857344 |
---|---|
Provider Name | Dr. Daniel Lollar |
First Address | Roanoke, VA 24016-4955 |
Second Address | Roanoke, VA 24016-4955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2009 |
Last Update Date | 10/12/2020 |