Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 0101269646 | VA |
NPI | 1013302595 |
---|---|
Provider Name | Logan David Kinch |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22903-2981 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2015 |
Last Update Date | 31/07/2021 |