Individual
FAHD DAEDOUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
435 KINGSCOTE LN, GLEN ALLEN, VA 23059-4675
(804) 549-7775
Mailing address
435 KINGSCOTE LN, GLEN ALLEN, VA 23059-4675
(804) 549-7775
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
002-00670711
VA
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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