Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 125.054202 | IL |
N | 207Q00000X | Family Doctor | MD443593 | PA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 0101252195 | VA |
NPI | 1457520090 |
---|---|
Provider Name | Dr. Reymond Damasco Pascual |
First Address | Newport News, VA 23606-4430 |
Second Address | Hampton, VA 23666-5846 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2008 |
Last Update Date | 07/02/2020 |