Provider Demographics
NPI:1124657168
Name:FIRDE, SOLOMON T
Entity type:Individual
Prefix:
First Name:SOLOMON
Middle Name:T
Last Name:FIRDE
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 1:8206 HAMPTON VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-2027
Mailing Address - Country:US
Mailing Address - Phone:804-335-8423
Mailing Address - Fax:
Practice Address - Street 1:8206 HAMPTON VALLEY DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-2027
Practice Address - Country:US
Practice Address - Phone:804-335-8423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver