Organization
CJW INFECTIOUS DISEASE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL SMITH (VP)
(804) 237-7760
Entity
Organization
Contact information
Practice address
7117 JAHNKE RD, RICHMOND, VA 23225-4017
(804) 228-6880
(804) 228-6883
Mailing address
7117 JAHNKE RD, RICHMOND, VA 23225-4017
(804) 228-6880
(804) 228-6883
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578501060
—
VA
01
—
DF7157
RR MEDICARE
—
Enumeration date
06/04/2006
Last updated
08/28/2007
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