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Individual

MRS. SULLIVAN DOUMONT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1830 PLAZA DR, WINCHESTER, VA 22601-6365
(540) 665-8414
Mailing address
1196 HITES RD, MIDDLETOWN, VA 22645-2002
(540) 539-2342

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110005994
VA
363AM0700X
Medical Physician Assistant
2647
OK
363AM0700X
Medical Physician Assistant
PA.0006194
CO

Other

Enumeration date
02/01/2016
Last updated
11/16/2023
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