Basic Information
Provider Information
NPI: 1780847665
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARUCH
FirstName: DANIEL
MiddleName: BRYAN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6350 CENTER DR STE 200
Address2:  
City: NORFOLK
State: VA
PostalCode: 235024107
CountryCode: US
TelephoneNumber: 7572135683
FaxNumber: 7572135762
Practice Location
Address1: 1950 GLENN MITCHELL DR STE 102
Address2:  
City: VIRGINIA BEACH
State: VA
PostalCode: 234560019
CountryCode: US
TelephoneNumber: 7573680437
FaxNumber: 7573680492
Other Information
ProviderEnumerationDate: 07/09/2008
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X10030832TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XP1621TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X269413NYN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RH0003X39125SCN Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
208000000X10030832TXN Allopathic & Osteopathic PhysiciansPediatrics 
207RH0003X0101263410VAY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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