Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 0101040387 | VA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 0101040387 | VA |
NPI | 1720057391 |
---|---|
Provider Name | Hallene A Maragh |
First Address | Richmond, VA 23220-4308 |
Second Address | Richmond, VA 23220-4308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 18/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1538128483 | GROUP NPI (01) | VA |
B06648 | (02) |