1487808176 NPI number — PATRICIA DRUMMOND COUSER CMT,LMT

Table of content: PATRICIA DRUMMOND COUSER CMT,LMT (NPI 1487808176)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487808176 NPI number — PATRICIA DRUMMOND COUSER CMT,LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COUSER
Provider First Name:
PATRICIA
Provider Middle Name:
DRUMMOND
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CMT,LMT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487808176
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
258 SHORECREST LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMPTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23669-6000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-754-8362
Provider Business Mailing Address Fax Number:
757-594-9830

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
753 THIMBLE SHOALS BLVD
Provider Second Line Business Practice Location Address:
SUITE 2A
Provider Business Practice Location Address City Name:
NEWPORT NEWS
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23606-3564
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-754-8362
Provider Business Practice Location Address Fax Number:
757-594-9830
Provider Enumeration Date:
11/09/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  184809 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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