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Individual

DR. DANIEL T THREAT JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4619 GREGORYS CHARTER CT, RICHMOND, VA 23236-1062
(804) 379-5488
(804) 379-5586
Mailing address
4619 GREGORYS CHARTER CT, RICHMOND, VA 23236-1062
(804) 379-5488
(804) 379-5586

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
0101054629
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005867100
VA
Enumeration date
11/21/2006
Last updated
07/09/2007
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