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Contact Information

DOMINION HEALTH MEDICAL ASSOC
2232 WILBORN AVE
SUITE F
SOUTH BOSTON, VA24592
 Phone: 434-517-8095
 Fax: 434-517-3887
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for DOMINION HEALTH MEDICAL ASSOC · (Female)

NPI Number 1427306315
Status Active
Credentials
Entity Individual
Enumeration date 08/27/2012
Last updated 02/10/2015 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • VA Other 0101251391 VIRGINIA LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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