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Individual

DAVID LEE TOLLIVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
110 HUFFARD DR, BLUEFIELD, VA 24605-9209
(276) 326-3376
(276) 326-3046
Mailing address
110 HUFFARD DR, BLUEFIELD, VA 24605-9209
(276) 326-3376
(276) 326-3046

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0102050026
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010043565
VA
Enumeration date
12/28/2005
Last updated
09/04/2009
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