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Individual

PHILIP EARL WAKEFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 RIVERSIDE CIR STE 300, ROANOKE, VA 24016-4962
(540) 581-0254
(540) 581-0120
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101049323
VA
207N00000X
Dermatology Physician
36846
NC

Other

Enumeration date
08/04/2006
Last updated
03/07/2023
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