Healthcare Provider Details

I. General information

NPI: 1215744669
Provider Name (Legal Business Name): BENJAMIN BIRD JAMES DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 E CLAY ST
RICHMOND VA
23298-5071
US

IV. Provider business mailing address

1200 E BROAD ST # 980257
RICHMOND VA
23298-5025
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-0996
  • Fax: 804-828-0648
Mailing address:
  • Phone: 804-715-2024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0116040503
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: