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Individual

MERVET EL ASSAL MAXIMOUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
416 DURANT ST, SOUTH HILL, VA 23970-1614
(434) 774-2500
(434) 447-4704
Mailing address
PO BOX 456, BRACEY, VA 23919-0456
(434) 774-2500
(434) 447-4704

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101053050
VA

Other

Enumeration date
01/03/2007
Last updated
07/08/2007
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