Healthcare Provider Details

I. General information

NPI: 1629207139
Provider Name (Legal Business Name): RAFFAELE JAMES MARCHIGIANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2009
Last Update Date: 04/22/2022
Certification Date: 04/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6251 E VIRGINIA BEACH BLVD STE 300
NORFOLK VA
23502-2800
US

IV. Provider business mailing address

6251 E VIRGINIA BEACH BLVD STE 300
NORFOLK VA
23502-2800
US

V. Phone/Fax

Practice location:
  • Phone: 757-261-5000
  • Fax: 757-962-5610
Mailing address:
  • Phone: 757-261-5000
  • Fax: 757-962-5610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101259913
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMT196162
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number294845
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberR-10035
License Number StateIA
# 5
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number294845
License Number StateNY
# 6
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number0101259913
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: