Individual
DR. NIRMALA VASA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
SOUTHSIDE VIRGINIA TRAINING CENTER, 26317 WEST WASHINGTON STREET EXT, PETERSBURG, VA 23803-0030
(804) 524-7294
(804) 524-7030
Mailing address
SOUTHSIDE VIRGINIA TRAINING CENTER, 26317 WEST WASHINGTON STREET EXT, PETERSBURG, VA 23803-0030
(804) 524-7294
(804) 524-7030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101034736
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101034736
LICENCE UNMBER
VA
Enumeration date
01/09/2006
Last updated
07/08/2007
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