Healthcare Provider Details

I. General information

NPI: 1801962386
Provider Name (Legal Business Name): COLON AND RECTAL SPECIALISTS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7605 FOREST AVE SUITE 308
RICHMOND VA
23229-4938
US

IV. Provider business mailing address

7605 FOREST AVE SUITE 308
RICHMOND VA
23229-4938
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-7077
  • Fax: 804-285-8120
Mailing address:
  • Phone: 804-288-7077
  • Fax: 804-285-8120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW J VORENBERG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 804-288-7077