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Individual

DR. EDWIN J POLVERINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1935 W MAIN ST, SALEM, VA 24153-3109
(540) 387-0441
(540) 389-7868
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102037045
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005622191
VA
Enumeration date
02/10/2006
Last updated
07/08/2022
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