Healthcare Provider Details

I. General information

NPI: 1730243486
Provider Name (Legal Business Name): VIRGINIA DIABETES AND ENDOCRINOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7650 E PARHAM RD STE 210
RICHMOND VA
23294-4306
US

IV. Provider business mailing address

348 BROWNS HILL CT
MIDLOTHIAN VA
23114-9511
US

V. Phone/Fax

Practice location:
  • Phone: 804-272-2702
  • Fax: 804-272-9355
Mailing address:
  • Phone: 804-272-2702
  • Fax: 804-272-9355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: REBECCA JONES
Title or Position: PRACTICE MANAGER
Credential:
Phone: 804-272-2702