Organization
HALIFAX INTERNAL MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE K KETCHERSID MD (OWNER)
(434) 517-3879
Entity
Organization
Contact information
Practice address
2232 WILBORN AVE, SOUTH BOSTON, VA 24592-1662
(434) 517-3879
Mailing address
2232 WILBORN AVE, SOUTH BOSTON, VA 24592-1662
(434) 517-3879
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
0101054916
VA
Other
Enumeration date
04/30/2009
Last updated
04/30/2009
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