Individual
DAISY S CLAUSTRO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2949 WEST FRONT STREET, RICHLANDS, VA 24641
(276) 596-6160
Mailing address
2951 WEST FRONT STREET, SUITE 3050, RICHLANDS, VA 24641
(276) 963-8504
(276) 963-6642
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101035736
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002187-000
WV MEDICAID
VA
01
—
258855
ANTHEM
VA
Enumeration date
06/16/2006
Last updated
07/08/2007
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