Physicians (M.D. and D.O.) (91)    PERSON CLASS (8932.1)

Name Value
PROVIDER TYPE Physicians (M.D. and D.O.)
CLASSIFICATION Physician/Osteopath
AREA OF SPECIALIZATION Pediatric Allergy & Immunology
STATUS Inactive
DATE INACTIVATED 2005-11-15 00:00:00
VA CODE V113800
INDIVIDUAL/NON INDIVIDUAL
MASTER ENTRY FOR VUID YES
VUID 5253836
EFFECTIVE DATE/TIME
  • 2018-04-02 15:35:13
    STATUS:   INACTIVE