Healthcare Provider Details

I. General information

NPI: 1780206532
Provider Name (Legal Business Name): MARC ASSAAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2020
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 LEIGH STREET
RICHMOND VA
23219
US

IV. Provider business mailing address

1200 E BROAD ST
RICHMOND VA
23298-5025
US

V. Phone/Fax

Practice location:
  • Phone: 804-628-3974
  • Fax: 804-828-2578
Mailing address:
  • Phone: 804-828-9783
  • Fax: 804-828-5613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number0116037452
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: