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Individual

DOUGLAS B SOUTHWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
109 BEE STREET, CHARLESTON VAMC, CHARLESTON, SC 29401-0000
(843) 477-0177
(843) 232-2441
Mailing address
109 BEE STREET, CHARLESTON VAMC, CHARLESTON, SC 29401-0000
(843) 477-0177
(843) 232-2441

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
42-0008157
VT
2084P0800X
Psychiatry Physician
Primary
7700
NH

Other

Enumeration date
11/28/2006
Last updated
02/04/2016
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