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Individual

JUSTIN R MIZE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
4092 FOXWOOD DR, SUITE 101, VIRGINIA BEACH, VA 23462-5225
(757) 467-4200
(757) 686-0541
Mailing address
PO BOX 7549, PORTSMOUTH, VA 23707-0549
(757) 686-3515
(757) 686-0541

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110003168
VA

Other

Enumeration date
10/21/2009
Last updated
10/25/2022
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