Individual
JAMES C VANDEWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20304 TIMBERLAKE RD, LYNCHBURG, VA 24502-7222
(434) 237-6471
(434) 237-8810
Mailing address
PO BOX 2489, FOREST, VA 24551-6489
(434) 382-1139
(434) 525-5748
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101027927
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005601665
—
VA
01
—
066023
ANTHEM
VA
01
—
080140296
MEDICARE RAILROAD
VA
01
—
RETIRED
RETIRED 05/02/2013
VA
Enumeration date
11/18/2005
Last updated
08/13/2013
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