Healthcare Provider Details

I. General information

NPI: 1679816094
Provider Name (Legal Business Name): WILLIAM RICHTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 06/13/2020
Certification Date: 06/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N GEORGE MASON DR STE 355
ARLINGTON VA
22205-3690
US

IV. Provider business mailing address

1625 N GEORGE MASON DR STE 355
ARLINGTON VA
22205-3690
US

V. Phone/Fax

Practice location:
  • Phone: 703-521-6662
  • Fax:
Mailing address:
  • Phone: 703-521-6662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101269599
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0101269599
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number0101269599
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: