Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 0101253920 | VA |
NPI | 1063556603 |
---|---|
Provider Name | Venkat Perumal |
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 | 16/02/2007 |
Last Update Date | 19/06/2013 |