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Individual

VIRGINIA M AVILAHASKELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1408 19TH AVE, FAIRBANKS, AK 99701-5903
(310) 908-8828
Mailing address
PO BOX 73889, DEPT OF FM, FAIRBANKS, AK 99707-3889
(310) 908-8828

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
6825
AK
207Q00000X
Family Medicine Physician
Primary
A89929
CA
208D00000X
General Practice Physician
A89929
CA

Other

Enumeration date
12/28/2005
Last updated
05/30/2012
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