Healthcare Provider Details

I. General information

NPI: 1073049748
Provider Name (Legal Business Name): JUAN PABLO ARAB VERDUGO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2017
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E LEIGH ST
RICHMOND VA
23298-5004
US

IV. Provider business mailing address

11507 BRIDGETENDER DR
HENRICO VA
23233-1782
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-9000
  • Fax: 804-828-5348
Mailing address:
  • Phone: 804-248-3139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0101281722
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: