Healthcare Provider Details

I. General information

NPI: 1700093515
Provider Name (Legal Business Name): PAUL DANIEL CHARRON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7605 FOREST AVE SUITE 308
RICHMOND VA
23229-4938
US

IV. Provider business mailing address

7605 FOREST AVE SUITE 308
RICHMOND VA
23229-4938
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-7077
  • Fax:
Mailing address:
  • Phone: 804-288-7077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD00047530
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number0101243276
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: