Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 0101023361 | VA |
NPI | 1154542728 |
---|---|
Provider Name | Dr. Thomas Jay Neviaser |
First Address | Rixeyville, VA 22737 |
Second Address | Rixeyville, VA 22737 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 08/07/2007 |