Individual
DWIGHT DEADMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SA
Contact information
Practice address
1401 JOHNSTON WILLIS DR, NORTH CHESTERFIELD, VA 23235-4730
(804) 483-6111
Mailing address
1401 JOHNSTON WILLIS DR, NORTH CHESTERFIELD, VA 23235-4730
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
0136000002
VA
Other
Enumeration date
01/01/2022
Last updated
01/01/2022
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