Provider Demographics
NPI:1447568076
Name:PIEDMONT FAMILY & OCCUPATIONAL MEDICINE
Entity Type:Organization
Organization Name:PIEDMONT FAMILY & OCCUPATIONAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD/
Authorized Official - Phone:434-791-7336
Mailing Address - Street 1:219 PARKER RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-4034
Mailing Address - Country:US
Mailing Address - Phone:434-791-7366
Mailing Address - Fax:434-791-3438
Practice Address - Street 1:219 PARKER RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-4034
Practice Address - Country:US
Practice Address - Phone:434-791-7366
Practice Address - Fax:434-791-3438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty