Provider Demographics
NPI:1932790854
Name:AUDEH, DOROTHY WINTERS (RPH)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:WINTERS
Last Name:AUDEH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HARBOUR VIEW DR
Mailing Address - Street 2:
Mailing Address - City:POQUOSON
Mailing Address - State:VA
Mailing Address - Zip Code:23662-1011
Mailing Address - Country:US
Mailing Address - Phone:757-715-1000
Mailing Address - Fax:
Practice Address - Street 1:35 HIDENWOOD SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2262
Practice Address - Country:US
Practice Address - Phone:757-595-1151
Practice Address - Fax:757-599-3920
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist