Organization
DOMINION HEALTH MEDICAL ASSOCIATES
Active
Other names
Halifax Urology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
STEWART NELSON (CEO)
(434) 517-3183
Entity
Organization
Contact information
Practice address
2232 WILBORN AVE, SOUTH BOSTON, VA 24592-1662
(434) 517-3100
Mailing address
PO BOX 777, SOUTH BOSTON, VA 24592-0777
(434) 517-3513
(434) 572-4549
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
0101037012
VA
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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