Individual
JOHN J DALLARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
142 S MAIN ST, DANVILLE, VA 24541-2922
(919) 810-9971
Mailing address
426 WYATT DR, DANVILLE, VA 24540-1054
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101043027
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005885833
—
VA
05
—
010313881
—
VA
05
—
89064Y6
—
NC
01
—
P00342773
RAILROAD MEDICARE
VA
Enumeration date
05/25/2006
Last updated
03/07/2023
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