Organization
DOMINION HEALTH MEDICAL ASSOC
Active
Other names
Sentara Halifax Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
CECIL HAZELWOOD (MANAGER (SDHG))
(434) 517-3515
Entity
Organization
Contact information
Practice address
2206 WILBORN AVE, SOUTH BOSTON, VA 24592
(434) 517-8075
(434) 517-3887
Mailing address
P.O. BOX 860, SOUTH BOSTON, VA 24592
(434) 517-3513
(434) 517-3887
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
0101251410
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101251410
LICENSE
VA
Enumeration date
04/30/2012
Last updated
02/10/2015
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up