Vidal, Luis E

Vidal, Luis E is an individual health care provider with primary practice located at 9300 Dewitt Loop , Fort Belvoir VA 22060-5285. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Vidal, Luis E can be contacted via phone (571) 231-0374.

Contact Information

Primary practice address
9300 Dewitt Loop Fort Belvoir VA 22060-5285
Phone: (571) 231-0374
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110008968 Virginia

Profile Details

NPI number 1902091986
LBN Legal business name Vidal, Luis E
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2007
Last updated Aug 10th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902091986 NPPES
Virginia Other 0110008968 VIRGINIA STATE BOARD OF MEDICINE PHYSICIAN ASSISTANT LICENSE

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