Provider Demographics
NPI:1679080246
Name:DRUMMOND, DARRYL GLENN
Entity Type:Individual
Prefix:MR
First Name:DARRYL
Middle Name:GLENN
Last Name:DRUMMOND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 OTTERDALE RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-6913
Mailing Address - Country:US
Mailing Address - Phone:804-564-2792
Mailing Address - Fax:
Practice Address - Street 1:1601 OTTERDALE RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-6913
Practice Address - Country:US
Practice Address - Phone:804-564-2792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist