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Individual

DANIEL B DRYSDALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D. PC

Contact information

Practice address
3645 S MAIN ST, BLACKSBURG, VA 24060-7018
(540) 951-0525
(540) 953-1539
Mailing address
3645 S MAIN ST, BLACKSBURG, VA 24060-7018
(540) 951-0525
(540) 953-1539

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101029249
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006374760
VA
01
064462
ANTHEM PROVIDER NUMBER
VA
01
1952631723
TYPE II DME NPI CORPORATE DMERC
VA
Enumeration date
06/20/2006
Last updated
10/13/2011
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