Provider Demographics
NPI:1073338562
Name:CULVER, JUSTIN DREW
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:DREW
Last Name:CULVER
Suffix:
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 1:9054 BREVET LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-6591
Mailing Address - Country:US
Mailing Address - Phone:804-484-4941
Mailing Address - Fax:888-484-1886
Practice Address - Street 1:9054 BREVET LN
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-6591
Practice Address - Country:US
Practice Address - Phone:804-484-4941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies