Healthcare Provider Details

I. General information

NPI: 1720054422
Provider Name (Legal Business Name): RICHARD H WINELAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 05/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MT CLEMENT PARK SUITE A
TAPPAHANNOCK VA
22560-5098
US

IV. Provider business mailing address

856 J CLYDE MORRIS BLVD SUITE A
NEWPORT NEWS VA
23601-1318
US

V. Phone/Fax

Practice location:
  • Phone: 804-443-8610
  • Fax: 804-443-8620
Mailing address:
  • Phone: 757-594-4006
  • Fax: 757-534-5190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101035719
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: