Healthcare Provider Details

I. General information

NPI: 1710991385
Provider Name (Legal Business Name): RICHARD J PAVER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 03/10/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 BATTLEFIELD BLVD N
CHESAPEAKE VA
23320-4901
US

IV. Provider business mailing address

5000 COX RD
GLEN ALLEN VA
23060-9263
US

V. Phone/Fax

Practice location:
  • Phone: 757-547-0688
  • Fax:
Mailing address:
  • Phone: 804-968-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102202166
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: