Individual
JOSE F DEMOYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1755 N MECKLENBURG AVE, SOUTH HILL, VA 23970-4080
(434) 584-5436
(434) 584-5495
Mailing address
PO BOX 623, SOUTH HILL, VA 23970-0623
(434) 584-5436
(434) 845-4955
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101053710
VA
208600000X
Surgery Physician
ME-53184
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578644373
—
VA
05
—
257234600
—
FL
01
—
348505
ANTHEM BCBS
VA
01
—
6344131
CIGNA
VA
01
—
784825
SOUTHERN HEALTH
VA
05
—
890632P
—
NC
01
—
DE8368
RR MEDICARE
VA
Enumeration date
10/18/2006
Last updated
12/20/2019
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