Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 0101231440 | VA |
NPI | 1003817974 |
---|---|
Provider Name | Richard R Gill |
First Address | Richmond, VA 23225-3007 |
Second Address | Glen Allen, VA 23059-8511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 22/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
005803560 | (05) | VA |
005867169 | (05) | VA |
C98139 | (02) | VA |
H40952 | (02) |