Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 0101023199 | VA |
NPI | 1477501500 |
---|---|
Provider Name | Dr. John Alexander Cardea |
First Address | Richmond, VA 23298-0153 |
Second Address | Richmond, VA 23298-5058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B06757 | (02) | VA |