Physicians (Other Roles) (645) PERSON CLASS (8932.1)
Name
Value
PROVIDER TYPE
Physicians (Other Roles)
CLASSIFICATION
Physician/Osteopath
AREA OF SPECIALIZATION
Laboratory Service Provider
STATUS
Inactive
DATE INACTIVATED
2005-11-15 00:00:00
VA CODE
V160101
INDIVIDUAL/NON
INDIVIDUAL
MASTER ENTRY FOR VUID
YES
VUID
5254982
EFFECTIVE DATE/TIME
2018-04-02 15:35:57
STATUS: INACTIVE
