Healthcare Provider Details

I. General information

NPI: 1174969794
Provider Name (Legal Business Name): NATHANIEL CALVIN WARNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E MARSHALL ST
RICHMOND VA
23298-5023
US

IV. Provider business mailing address

1000 E. MARSHALL ST VMI BUILDING, 2ND FLOOR, ROOM 205
RICHMOND VA
23298
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-0951
  • Fax:
Mailing address:
  • Phone: 804-828-9711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number0101260708
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0101260708
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101260708
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: