Individual
AIVI N MASTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9600 PATTERSON AVE, RICHMOND, VA 23229
(804) 741-6200
(804) 741-6213
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101259787
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTANC
VA
Enumeration date
04/12/2013
Last updated
08/21/2019
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