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Individual

DR. COREY PASSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2542 LANGHORNE RD, LYNCHBURG, VA 24501-1602
(434) 200-5297
Mailing address
1204 FENWICK DR, LYNCHBURG, VA 24502-2112
(434) 200-3656

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101243684
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
203639329027
TRICARE
01
203639329029
TRICARE
01
203639329030
TRICARE
01
358897
ANTHEM
01
359504
ANTHEM
01
362160
ANTHEM
Enumeration date
05/23/2007
Last updated
02/05/2009
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