Healthcare Provider Details

I. General information

NPI: 1861179160
Provider Name (Legal Business Name): FRANCIS IKECHI OGBONNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2023
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E MARSHALL ST
RICHMOND VA
23298-5023
US

IV. Provider business mailing address

203 HULL ST APT 2E
RICHMOND VA
23224-4273
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-9000
  • Fax:
Mailing address:
  • Phone: 973-727-5501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number0001308212
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: