Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 0101059229 | VA |
NPI | 1003874538 |
---|---|
Provider Name | Dr. Richard Ralph Pagano |
First Address | Danville, VA 24541-2936 |
Second Address | Danville, VA 24541-2936 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 20/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0625W | BCBS (01) | NC |
284241 | ANTHEM (01) | VA |
5715776 | (05) | VA |
690625W | (05) | NC |
C35991 | (02) |