Provider Demographics
NPI:1982023990
Name:PRIVETTE, EMILY DARE (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:DARE
Last Name:PRIVETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 PETER JEFFERSON PKWY
Mailing Address - Street 2:STE 230
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8835
Mailing Address - Country:US
Mailing Address - Phone:434-984-2400
Mailing Address - Fax:434-984-1147
Practice Address - Street 1:3008 PICKETT RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-6006
Practice Address - Country:US
Practice Address - Phone:919-286-7903
Practice Address - Fax:919-286-7151
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101264060207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology