Healthcare Provider Details

I. General information

NPI: 1437565256
Provider Name (Legal Business Name): CHAD JOSEPH RIZZARDI D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 KEMPSVILLE RD STE 104
NORFOLK VA
23502-3927
US

IV. Provider business mailing address

844 KEMPSVILLE RD STE 104
NORFOLK VA
23502-3927
US

V. Phone/Fax

Practice location:
  • Phone: 757-395-1880
  • Fax: 757-995-7051
Mailing address:
  • Phone: 757-395-1880
  • Fax: 757-995-7051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0103301226
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC006570
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0103301226
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: