Healthcare Provider Details

I. General information

NPI: 1568849495
Provider Name (Legal Business Name): DAVID FRANCIS REILLY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GRESHAM DR
NORFOLK VA
23507-1904
US

IV. Provider business mailing address

6275 E VIRGINIA BEACH BLVD STE 300
NORFOLK VA
23502-2851
US

V. Phone/Fax

Practice location:
  • Phone: 757-388-3000
  • Fax:
Mailing address:
  • Phone: 757-466-0089
  • Fax: 757-466-8017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA162735
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberA162735
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101285214
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: