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Organization
DANVILLE ENT ASSOCIATES INC
Active
Organization
DANVILLE ENT ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL J MEADEMA MD (PRESIDENT)
(434) 792-0830
Entity
Organization
Contact information
Practice address
159 EXECUTIVE DRIVE, SUITE C, DANVILLE, VA 24541-4160
(434) 792-0830
(434) 792-0468
Mailing address
159 EXECUTIVE DR, SUITE C, DANVILLE, VA 24541-4160
(434) 792-0830
(434) 792-0468
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
900652
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM2207
MEDICARE OF GA
GA
Enumeration date
09/25/2006
Last updated
01/11/2008
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