Individual
JARED WAYNE DYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
417 N 11TH ST, RICHMOND, VA 23298-5002
(804) 828-8786
(804) 828-5466
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0102205574
VA
Other
Enumeration date
04/13/2016
Last updated
02/06/2020
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