| Name | Value |
|---|---|
| PROVIDER TYPE | Allopathic & Osteopathic Physicians |
| CLASSIFICATION | Allergy & Immunology |
| DEFINITION | A physician who specializes in the diagnosis, treatment, and management of allergies. |
| AREA OF SPECIALIZATION | Allergy |
| STATUS | Active |
| VA CODE | V180101 |
| X12 CODE | 207KA0200X |
| SPECIALTY CODE | 03 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5251469 |
| EFFECTIVE DATE/TIME |
|