| Name | Value |
|---|---|
| PROVIDER TYPE | Allopathic & Osteopathic Physicians |
| CLASSIFICATION | Family Medicine |
| DEFINITION | The NUCC recommends this code not be used. Choose a more appropriate code. |
| AREA OF SPECIALIZATION | Adult Medicine |
| STATUS | Active |
| VA CODE | V180703 |
| X12 CODE | 207QA0505X |
| SPECIALTY CODE | 08 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5251607 |
| EFFECTIVE DATE/TIME |
|