| Name | Value |
|---|---|
| PROVIDER TYPE | Allopathic & Osteopathic Physicians |
| CLASSIFICATION | Surgery |
| DEFINITION | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| AREA OF SPECIALIZATION | Vascular Surgery |
| STATUS | Active |
| VA CODE | V183107 |
| X12 CODE | 2086S0129X |
| SPECIALTY CODE | 77 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5251412 |
| EFFECTIVE DATE/TIME |
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