Individual
ROMULO ABRANTES FAJARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
340 ANDERSON HOLLOW RD, NORTON, VA 24273-1100
(276) 679-5880
(276) 679-9156
Mailing address
999 EXECUTIVE PARK BLVD, SUITE 201, KINGSPORT, TN 37660-4632
(423) 224-3250
(423) 224-3258
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101221509
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
284730
ANTHEM BCBS
—
05
—
5835810
—
VA
05
—
6400803000
—
KY
Enumeration date
11/04/2005
Last updated
06/10/2008
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