Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 0101034125 | VA |
NPI | 1073579868 |
---|---|
Provider Name | Dr. Richard D. Redman |
First Address | Richmond, VA 23226-3787 |
Second Address | Richmond, VA 23226-3786 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B05436 | (02) | VA |