Provider Demographics
NPI:1639181704
Name:POU, JAVIER A (MD)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:A
Last Name:POU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:PENN LAIRD
Mailing Address - State:VA
Mailing Address - Zip Code:22846-0085
Mailing Address - Country:US
Mailing Address - Phone:540-437-0087
Mailing Address - Fax:540-642-1357
Practice Address - Street 1:3320 EMMAUS RD
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:22801-2685
Practice Address - Country:US
Practice Address - Phone:540-437-0087
Practice Address - Fax:540-642-1357
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101234913207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH92108Medicare UPIN