Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 0101232555 | VA |
NPI | 1033179395 |
---|---|
Provider Name | Richard A Gayle |
First Address | Richmond, VA 23223-7071 |
Second Address | Richmond, VA 23223-7071 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 30/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H62591 | (02) |