Healthcare Provider Details

I. General information

NPI: 1174012496
Provider Name (Legal Business Name): PATRICK RAVE CHING MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E BROAD ST
RICHMOND VA
23298-5025
US

IV. Provider business mailing address

PO BOX 780125
PHILADELPHIA PA
19178-0125
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-6163
  • Fax: 804-828-3097
Mailing address:
  • Phone: 804-922-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number0101278942
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: