Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 0101251368 | VA |
NPI | 1013168673 |
---|---|
Provider Name | Dr. Samantha Alexandra Vergano |
First Address | Norfolk, VA 23505-3155 |
Second Address | Norfolk, VA 23507-1910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2008 |
Last Update Date | 08/11/2012 |