Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 0101038197 | VA |
NPI | 1053387266 |
---|---|
Provider Name | Dr. Paul D Richards |
First Address | Roanoke, VA 24014-2419 |
Second Address | Salem, VA 24153-7474 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 02/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5854610 | (05) | VA |
B60134 | (02) |