Healthcare Provider Details

I. General information

NPI: 1679899157
Provider Name (Legal Business Name): MARIKO HAGIWARA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIKO SASO-HAGIWARA

II. Dates (important events)

Enumeration Date: 04/09/2010
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 E MARSHALL ST
RICHMOND VA
23298-5028
US

IV. Provider business mailing address

PO BOX 780125
PHILADELPHIA PA
19178-0125
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-3144
  • Fax: 804-628-7104
Mailing address:
  • Phone: 804-922-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD-44493
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101289410
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberP8360
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-44493
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: