General Thoracic Surgery Pc

NPI 1407006018 - Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X

NPI Details
NPI 1407006018
Enumeration Date 09/19/2008
Last Updated 09/19/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name OLUSOLA O OLUSOLA
Position OWNER
Phone (276) 596-6715
Fax (276) 596-6717
Practice Location
3150 CLINCH ST
SUITE 104
RICHLANDS VA, 24641-2159, US
Phone (276) 596-6715
Fax (276) 596-6717
Business Location
3150 CLINCH ST
SUITE 104
RICHLANDS VA, 24641-2159, US
Phone (276) 596-6715
Fax (276) 596-6717
Toxanomy
Taxonomy Code 208G00000X
License State Virginia
License Number 0101240724
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According to our database, General Thoracic Surgery Pc NPI is 1407006018, taxonomy code is 208G00000X and license number is 0101240724, license state is located at Virginia. General Thoracic Surgery Pc physically located at 3150 Clinch St, Richlands VA, 24641-2159. NPI Number 1033115704 has the healthcare provider type.

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1407006018 NPI number is provided on an as is basis without warranty of any kind. 1407006018 is maintained by the National Plan & Provider Enumeration System. The contents of General Thoracic Surgery Pc are for informational purposes only.