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General NPI Number Information
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NPI Number | 1134403090
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Entity Type | Organization
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Legal Business Name | CLINCH VALLEY VASCULAR SURGERY ASSOCIATES
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Dates
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Enumeration Date | 10/10/2011
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 6719 GOV G. C. PEERY HIGHWAY 2600
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City | RICHLANDS
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State | VA
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Zip | 24641
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Country | US
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Telephone | 276-963-0333
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Fax | 276-963-0222
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Provider Business Mailing Address
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Address Line | 6719 GOV G. C. PEERY HIGHWAY 2600
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City | RICHLANDS
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State | VA
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Zip | 24641
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Country | US
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Telephone | 276-963-0333
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Fax | 276-963-0222
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Authorized Official
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Title or Position | OWNER AND MANAGER
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Name | DR. DAVID CHRISTOPHER CASSADA
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Credential | M.D.
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Telephone | 276-963-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State | VA
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