Individual
DOUGLAS ALLYN POTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
636 S MONTE VISTA DR, GLADE SPRING, VA 24340-2712
(276) 429-5163
(276) 429-5515
Mailing address
636 S MONTE VISTA DR, GLADE SPRING, VA 24340-2712
(276) 429-5163
(276) 429-5515
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101034124
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007610131
—
VA
05
—
1194722652
—
VA
01
—
240748
ANTHEM
VA
01
—
610722601
DEPT OF LABOR
VA
01
—
P01372202
RR MEDICARE
VA
Enumeration date
06/30/2005
Last updated
02/22/2017
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