Individual
MRS. LYDIA NOVRUZOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, ABINGDON, VA 24211-7664
(276) 258-1800
(276) 258-1805
Mailing address
16000 JOHNSTON MEMORIAL DR, ABINGDON, VA 24211-7664
(276) 258-1800
(276) 258-1805
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110005362
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962803361
—
VA
Enumeration date
09/04/2014
Last updated
02/21/2017
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