Healthcare Provider Details

I. General information

NPI: 1942538517
Provider Name (Legal Business Name): VIRGINIA PSYCHIATRY GROUP DBA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2009
Last Update Date: 11/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7603 FOREST AVE SUITE 209
RICHMOND VA
23229-4942
US

IV. Provider business mailing address

7603 FOREST AVE SUITE 209
RICHMOND VA
23229-4942
US

V. Phone/Fax

Practice location:
  • Phone: 804-282-7770
  • Fax: 804-282-3752
Mailing address:
  • Phone: 804-282-7770
  • Fax: 804-282-3752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number0117004089
License Number StateVA

VIII. Authorized Official

Name: DR. DEMETRIOS JULIUS
Title or Position: MEDICAL DIRECTOR
Credential: M.D
Phone: 804-282-7770