Healthcare Provider Details

I. General information

NPI: 1982380952
Provider Name (Legal Business Name): JUDE AL QAQAA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E LEIGH ST
RICHMOND VA
23298-5004
US

IV. Provider business mailing address

PO BOX 980257
RICHMOND VA
23298-0257
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-2161
  • Fax: 804-807-7953
Mailing address:
  • Phone: 804-828-9783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number0116041820
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: