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Organization
DOMINION HEALTH MEDICAL ASSOC.
Active
Organization
DOMINION HEALTH MEDICAL ASSOC.
Active
Other names
Sentara Volens Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
CECIL HAZELWOOD (MANAGER SDHG)
(434) 517-3590
Entity
Organization
Contact information
Practice address
15210 L. P. BAILEY MEMORIAL HWY, SOUTH BOSTON, VA 24592
(434) 349-3113
(434) 517-3887
Mailing address
P.O. BOX 860, SOUTH BOSTON, VA 24592
(434) 517-3513
(434) 517-3887
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
0101032102
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007610661
—
VA
Enumeration date
10/02/2006
Last updated
02/10/2015
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