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NPI Code Detail

MEDICARE: TRUDY L RICKMAN M.D.

MEDICARE:   TRUDY L RICKMAN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology Physician0101230946VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1141841OTHERVASOUTHERN HEALTH
2218557OTHERVAANTHEM BLUE CROSS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4295546OTHERVAMAMSI
5028052OTHERVACIGNA
6541497804OTHERVATRICARE CHAMPUS
77273281OTHERVAAETNA
833843OTHERVACARENET

General Provider Information

NPI Number : 1356347397
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRUDY L RICKMAN M.D.
Provider Business Mailing Address
First Line : 1603 SANTA ROSA RD
Second Line : RM 102
City : RICHMOND
State : VA
Zip : 23229-5010
Country : US
Telephone Number : 804-288-6750
Fax Number : 805-288-6753
Provider Business Practice Location Address
First Line : 7605 FOREST AVE
Second Line : STE 109
City : RICHMOND
State : VA
Zip : 23229-4938
Country : US
Telephone Number : 804-285-6390
Fax Number : 804-285-6393
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 08/31/2015

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Directions to “ TRUDY L RICKMAN M.D.” Practice Location

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