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Individual

GUNVOR E WEIRICK-SACKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
4687 POUNCEY TRACT RD, GLEN ALLEN, VA 23059-5802
(804) 422-5437
(804) 474-9071
Mailing address
4687 POUNCEY TRACT RD, GLEN ALLEN, VA 23059-5802
(804) 422-5437
(804) 474-9071

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101043918
VA
208000000X
Pediatrics Physician
Primary
0101043918
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006726976
VA
05
1841283660
VA
Enumeration date
08/26/2005
Last updated
07/17/2013
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