| Name | Value |
|---|---|
| PROVIDER TYPE | Allopathic & Osteopathic Physicians |
| CLASSIFICATION | Preventive Medicine |
| DEFINITION | A physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction. |
| AREA OF SPECIALIZATION | Addiction Medicine |
| STATUS | Active |
| VA CODE | V182809 |
| X12 CODE | 2083A0300X |
| SPECIALTY CODE | 79 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5327613 |
| EFFECTIVE DATE/TIME |
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