Carlos D Branch
Individual provider Active NPI Driver · Suffolk, VA
NPI 1891313623 · NPPES record last updated Jul 8, 2020
Key facts
- NPI
- 1891313623
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 426 Woodruff St
Suffolk, VA 23434-3455 - Phone
- (757) 292-5878
- NPI assigned
- Jul 8, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
426 Woodruff St
Suffolk, VA 23434-3455
Mailing address
426 Woodruff St
Suffolk, VA 23434-3455
Phone (757) 292-5878
Other providers in Suffolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.