Physicians (M.D. and D.O.) (164) PERSON CLASS (8932.1)

Name	Value
PROVIDER TYPE	Physicians (M.D. and D.O.)
CLASSIFICATION	Surgery, Plastic Facial, Otolaryngology
STATUS	Inactive
DATE INACTIVATED	1998-10-20 00:00:00
VA CODE	V117600
reserved	P75
INDIVIDUAL/NON	INDIVIDUAL
MASTER ENTRY FOR VUID	YES
VUID	5254118
EFFECTIVE DATE/TIME	2018-04-02 15:35:29 STATUS: INACTIVE