Individual
MISS AMANDA RAQUEL MEDINA PADILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
813 EXETER CT, CHARLOTTESVLE, VA 22901-1761
(787) 955-7401
Mailing address
PO BOX 1140, STANARDSVILLE, VA 22973-1140
(434) 939-9002
Taxonomy
Speciality
Code
Description
License number
State
207ZP0213X
Pediatric Pathology Physician
Primary
2204000372
VA
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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