Healthcare Provider Details

I. General information

NPI: 1720052319
Provider Name (Legal Business Name): ANTHONY MICHAEL GIORDANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 11/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 GLENSIDE DR
RICHMOND VA
23226-3769
US

IV. Provider business mailing address

1405 JOHNSTON WILLIS DR
RICHMOND VA
23235-4730
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-8308
  • Fax: 804-288-7562
Mailing address:
  • Phone: 804-282-1413
  • Fax: 804-320-5757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number0101033161
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: