Healthcare Provider Details

I. General information

NPI: 1154312247
Provider Name (Legal Business Name): DONALD E SOLES JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2005
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 GUMWOOD DR SUITE A
SMITHFIELD VA
23430-6087
US

IV. Provider business mailing address

206 GUMWOOD DR SUITE A
SMITHFIELD VA
23430-6087
US

V. Phone/Fax

Practice location:
  • Phone: 757-365-9090
  • Fax: 757-365-9095
Mailing address:
  • Phone: 757-365-9090
  • Fax: 757-365-9095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101045475
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: