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Individual

MR. PAUL T VERSAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1849 OLD DONATION PKWY, VIRGINIA BEACH, VA 23454
(757) 422-8476
Mailing address
1115 BOULDERS PKWY STE 200, NORTH CHESTERFIELD, VA 23225-4067
(804) 560-5595
(804) 560-9029

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110840382
VA
363AM0700X
Medical Physician Assistant
0110840382
VA
363AS0400X
Surgical Physician Assistant
0110840382
VA

Other

Enumeration date
07/15/2006
Last updated
09/17/2020
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