Organization
COMMONWEALTH OF VIRGINIA SOUTHSIDE VA TRAINING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HOLLAND JR. M.D. (FACILITY DIRECTOR)
(804) 524-7537
Entity
Organization
Contact information
Practice address
26317 W. WASHINGTON STREET, PETERSBURG, VA 23803-0000
(804) 524-7537
Mailing address
PO BOX 4030, PETERSBURG, VA 23803-0030
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO2260
PHYSICIAN GROUP NUMBER
VA
Enumeration date
12/19/2006
Last updated
08/22/2020
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