Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 104556260 | VA |
NPI | 1811994494 |
---|---|
Provider Name | Dr. Michael P Placide |
First Address | Midlothian, VA 23112-2452 |
Second Address | Midlothian, VA 23112-2160 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V00412 | (02) | VA |