Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 0401004495 | VA |
NPI | 1871556910 |
---|---|
Provider Name | Mr. John Arthur Svirsky |
First Address | Richmond, VA 23298-0566 |
Second Address | Richmond, VA 23298-5064 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 14/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
179972 | ANTHEM ID NUMBER (01) | VA |
P00291863 | RAILROAD MEDICARE (01) | |
T90537 | (02) | VA |