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Organization

DOMINION HEALTH MEDICAL ASSOC

Active
Other names
Sentara Halifax Pediatrics
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CECIL HAZELWOOD (MANAGER)
(434) 517-3515
Entity
Organization

Contact information

Practice address
101 AUBREYS LOOP, SOUTH BOSTON, VA 24592-5054
(434) 517-3879
(434) 517-3989
Mailing address
PO BOX 860, SOUTH BOSTON, VA 24592-0860
(434) 517-3513
(434) 572-4549

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
11/04/2014
Last updated
11/04/2014
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