Healthcare Provider Details
I. General information
NPI: 1043274251
Provider Name (Legal Business Name): DAVID F TRENT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/14/2006
Last Update Date: 10/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6605 W BROAD ST SUITE A
RICHMOND VA
23230-1714
US
IV. Provider business mailing address
7202 GLEN FOREST DR SUITE 200
RICHMOND VA
23226-3781
US
V. Phone/Fax
- Phone: 804-287-3000
- Fax: 804-285-2981
- Phone: 804-673-0134
- Fax: 804-673-1796
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 0101039052 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: