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Individual

DR. PAUL VINCENT VISCUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1240 LEE ST, CHARLOTTESVILLE, VA 22908-0817
(434) 924-9333
(434) 244-7526
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
S4579
TX
207RX0202X
Medical Oncology Physician
Primary
0101274985
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
421872901
TX
01
421872902
MEDICAID- CSHCN
TX
Enumeration date
04/09/2016
Last updated
08/10/2023
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