Physicians (M.D. and D.O.) (600) PERSON CLASS (8932.1)

Name	Value
PROVIDER TYPE	Physicians (M.D. and D.O.)
CLASSIFICATION	Physician/Osteopath
AREA OF SPECIALIZATION	Sports Medicine
STATUS	Inactive
DATE INACTIVATED	2005-11-15 00:00:00
VA CODE	V118332
INDIVIDUAL/NON	INDIVIDUAL
MASTER ENTRY FOR VUID	YES
VUID	5254235
EFFECTIVE DATE/TIME	2018-04-02 15:35:34 STATUS: INACTIVE