Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 207PE0004X | VA |
NPI | 1205942596 |
---|---|
Provider Name | Dr. Steven M Bandy |
First Address | Abingdon, VA 24211-7659 |
Second Address | Abingdon, VA 24211-7659 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 24/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1205942596 | (05) | VA |
H07041 | (02) | VA |