Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 0101241904 | VA |
NPI | 1043428410 |
---|---|
Provider Name | Madeline Adams Dillon |
First Address | Skyland, NC 28776-2153 |
Second Address | Charlottesville, VA 22911-3642 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 07/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAA102934 | MEDICARE PTAN (01) | VA |