Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 0401008709 | VA |
NPI | 1073521001 |
---|---|
Provider Name | Dr. Karen Sonnone Mcandrew |
First Address | Richmond, VA 23238 |
Second Address | Richmond, VA 23238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8400105 | (05) | VA |
U74256 | (02) |