Organization
EDUARDO T TOLOSA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDUARDO T TOLOSA MD (PC PRESIDENT)
(276) 988-6559
Entity
Organization
Contact information
Practice address
984 BEN BOLT AVE, TAZEWELL, VA 24651-9706
(276) 988-6559
(276) 988-6550
Mailing address
984 BEN BOLT AVE, P.O. BOX 837, TAZEWELL, VA 24651-9706
(276) 988-6559
(276) 988-6550
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0101022191
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720008485
—
VA
Enumeration date
01/26/2010
Last updated
09/24/2010
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