Provider Demographics
NPI:1700530219
Name:DARDEN, XAVIER JR
Entity Type:Individual
Prefix:MR
First Name:XAVIER
Middle Name:
Last Name:DARDEN
Suffix:JR
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 1:12960 CRESCENT GRN # 203-7
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-5570
Mailing Address - Country:US
Mailing Address - Phone:804-683-7100
Mailing Address - Fax:
Practice Address - Street 1:12960 CRESCENT GRN # 203-7
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-5570
Practice Address - Country:US
Practice Address - Phone:804-683-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver