Individual
XAVIER A.R. PREUD'HOMME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2017 JEFFERSON ST SW, ROANOKE, VA 24014-2419
(540) 981-8025
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5352
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2006-00572
NC
2084P0800X
Psychiatry Physician
Primary
0101266623
VA
2084P0800X
Psychiatry Physician
2006-00572
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06157812
ECFMG
—
Enumeration date
06/30/2006
Last updated
08/11/2023
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