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Individual

CHARLES D PRICE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
107 DMV DRIVE, KILMARNOCK, VA 22482
(804) 435-3103
(804) 435-6695
Mailing address
107 DMV DRIVE, PO BOX 1599, KILMARNOCK, VA 22482
(804) 435-3103
(804) 435-6695

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101020644
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
015959
ANTHEM
VA
05
48140
VA
Enumeration date
12/06/2006
Last updated
07/08/2007
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