Healthcare Provider Details

I. General information

NPI: 1316952716
Provider Name (Legal Business Name): DERMATOLOGY ASSOCIATES OF RICHMOND PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6946 FOREST AVE STE 200
RICHMOND VA
23230-1706
US

IV. Provider business mailing address

7201 GLEN FOREST DR STE 100
RICHMOND VA
23226-3759
US

V. Phone/Fax

Practice location:
  • Phone: 804-549-4030
  • Fax: 804-549-4032
Mailing address:
  • Phone: 804-549-4030
  • Fax: 804-549-4032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN L CROUCH
Title or Position: CREDENTIALING
Credential:
Phone: 804-939-6186