Healthcare Provider Details

I. General information

NPI: 1194162388
Provider Name (Legal Business Name): HUNTER FIRST ASSISTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2013
Last Update Date: 05/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 SPRING GLEN DR
CHESTERFIELD VA
23832-8829
US

IV. Provider business mailing address

9600 SPRING GLEN DR
CHESTERFIELD VA
23832-8829
US

V. Phone/Fax

Practice location:
  • Phone: 804-306-5514
  • Fax: 804-275-7574
Mailing address:
  • Phone: 804-306-5514
  • Fax: 804-275-7574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK DOUGLAS HUNTER
Title or Position: CSA
Credential:
Phone: 804-306-5514