Healthcare Provider Details

I. General information

NPI: 1134175805
Provider Name (Legal Business Name): GEORGE A. PARKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 03/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5855 BREMO RD SUITE 506
RICHMOND VA
23226-1926
US

IV. Provider business mailing address

5855 BREMO RD SUITE 506
RICHMOND VA
23226-1926
US

V. Phone/Fax

Practice location:
  • Phone: 804-285-3225
  • Fax: 804-285-0360
Mailing address:
  • Phone: 804-285-3225
  • Fax: 804-285-0360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number0101032560
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: