| Name | Value |
|---|---|
| PROVIDER TYPE | Allopathic & Osteopathic Physicians |
| CLASSIFICATION | Resident, Allopathic (includes Interns, Residents, Fellows) |
| DEFINITION | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. (Allopathic Interns, Residents, Fellows) |
| STATUS | Active |
| VA CODE | V115500 |
| X12 CODE | 390200000X |
| SPECIALTY CODE | 01 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5252099 |
| EFFECTIVE DATE/TIME |
|