Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 0438000010 | VA |
NPI | 1093882334 |
---|---|
Provider Name | Dr. David Eric Redmon |
First Address | Winchester, VA 22601-4432 |
Second Address | Winchester, VA 22601-4432 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 08/07/2007 |