Organization
INSTITUTE OF ADVANCED ENT SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL SMITH (VP)
(804) 237-7760
Entity
Organization
Contact information
Practice address
2200 PUMP RD, SUITE 240, RICHMOND, VA 23233-3539
(804) 747-7427
(804) 747-7429
Mailing address
2200 PUMP RD, SUITE 240, RICHMOND, VA 23233-3539
(804) 747-7427
(804) 747-7429
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477681823
—
VA
Enumeration date
02/28/2007
Last updated
10/17/2007
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