Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 0101059311 | VA |
NPI | 1134164635 |
---|---|
Provider Name | Dr. Lewis T Ladocsi |
First Address | Midlothian, VA 23113-6836 |
Second Address | Richmond, VA 23233-7460 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6901417 | (05) | VA |
H09773 | (02) | VA |