Organization
DOMINION HEALTH MEDICAL ASSOC
Active
Other names
Sentora Halifax urology
Organization subpart
No
Provider details
NPI number
Authorized official
CECIL HAZELWOOD (MANAGER/SDHC))
(434) 517-3515
Entity
Organization
Contact information
Practice address
2232 WILBORN AVE, SUITE C, SOUTH BOSTON, VA 24592
(434) 517-8893
(434) 517-3887
Mailing address
P.O. BOX 860, SOUTH BOSTON, VA 24592
(434) 517-3513
(434) 517-3887
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
0101037012
VA
Other
Enumeration date
07/03/2008
Last updated
02/10/2015
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