Physicians (M.D. and D.O.) (20) PERSON CLASS (8932.1)
Name
Value
PROVIDER TYPE
Physicians (M.D. and D.O.)
CLASSIFICATION
Physician/Osteopath
AREA OF SPECIALIZATION
Sports Medicine: Family Practice
STATUS
Inactive
DATE INACTIVATED
2005-11-15 00:00:00
VA CODE
V110902
INDIVIDUAL/NON
INDIVIDUAL
MASTER ENTRY FOR VUID
YES
VUID
5253590
EFFECTIVE DATE/TIME
2018-04-02 15:35:03
STATUS: INACTIVE
