Organization
DIABETES, ENDOCRINE AND INTERNAL MEDICINE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY L SALLE (BUSINESS MANAGER)
(804) 272-7565
Entity
Organization
Contact information
Practice address
1475 JOHNSTON WILLIS DR, NORTH CHESTERFIELD, VA 23235-4730
(804) 272-7564
(804) 272-9325
Mailing address
1475 JOHNSTON WILLIS DR, NORTH CHESTERFIELD, VA 23235-4730
(804) 272-7564
(804) 272-9325
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101026634
VA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
0101025435
VA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
0101237679
VA
Other
Enumeration date
09/14/2006
Last updated
08/08/2014
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