Healthcare Provider Details

I. General information

NPI: 1083316152
Provider Name (Legal Business Name): DIANA SADAIEVA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 06/28/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E LEIGH ST FL 14
RICHMOND VA
23298-5004
US

IV. Provider business mailing address

PO BOX 980257
RICHMOND VA
23298-0257
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-2161
  • Fax:
Mailing address:
  • Phone: 804-828-3510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number0101289534
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: