Healthcare Provider Details

I. General information

NPI: 1346430725
Provider Name (Legal Business Name): HDH THORACIC SURGEONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2004 BREMO RD SUITE 103
RICHMOND VA
23226-2442
US

IV. Provider business mailing address

2004 BREMO RD SUITE 103
RICHMOND VA
23226-2442
US

V. Phone/Fax

Practice location:
  • Phone: 804-565-0383
  • Fax:
Mailing address:
  • Phone: 804-565-0383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: CAROL SMITH
Title or Position: VP
Credential:
Phone: 804-565-0383