Healthcare Provider Details

I. General information

NPI: 1154813814
Provider Name (Legal Business Name): NASRATULLAH OBAIDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E MARSHALL ST # 980509
RICHMOND VA
23298
US

IV. Provider business mailing address

1250 E MARSHALL ST # 980509
RICHMOND VA
23298-5051
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-9726
  • Fax:
Mailing address:
  • Phone: 804-828-9726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD211739
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0116032150
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: