Provider Demographics
NPI:1194952291
Name:VIRGINIA PAIN CENTER INC.
Entity type:Organization
Organization Name:VIRGINIA PAIN CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHHEANY
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:UNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-725-7364
Mailing Address - Street 1:5372 FALLOWATER LN
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-0907
Mailing Address - Country:US
Mailing Address - Phone:540-725-7364
Mailing Address - Fax:540-725-7368
Practice Address - Street 1:5372 FALLOWATER LN
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-0907
Practice Address - Country:US
Practice Address - Phone:540-725-7364
Practice Address - Fax:540-725-7368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA0101242119207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty