Healthcare Provider Details

I. General information

NPI: 1538842059
Provider Name (Legal Business Name): RAFAEL GARCIA DE OLIVEIRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 09/21/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 JENNICK DR
COLONIAL HEIGHTS VA
23834-4905
US

IV. Provider business mailing address

PO BOX 780125
PHILADELPHIA PA
19178-0125
US

V. Phone/Fax

Practice location:
  • Phone: 804-526-4888
  • Fax: 804-424-5401
Mailing address:
  • Phone: 804-526-5888
  • Fax: 804-524-5401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number0101289651
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: