Physicians (M.D. and D.O.) (24) PERSON CLASS (8932.1)

Name	Value
PROVIDER TYPE	Physicians (M.D. and D.O.)
CLASSIFICATION	Intern, Allopathic
STATUS	Inactive
DATE INACTIVATED	2005-05-03 00:00:00
VA CODE	V111300
INDIVIDUAL/NON	INDIVIDUAL
MASTER ENTRY FOR VUID	YES
VUID	5253602
EFFECTIVE DATE/TIME	2018-04-02 15:35:09 STATUS: INACTIVE