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General NPI Number Information
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NPI Number | 1801934682
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Entity Type | Individual
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Provider Name | GIACOMO A RICCIARELLI M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 02/28/2020
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Provider Practice Location Address
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Address Line | 263 MCLAWS CIRCLE SUITE 105
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-5629
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Country | US
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Telephone | 757-941-5600
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Fax | 757-564-0557
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Provider Business Mailing Address
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Address Line | PO BOX 1239
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City | TROY
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State | MI
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Zip | 48099-1239
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Country | US
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Telephone | 248-824-6600
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Fax | 855-618-6655
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101029718
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101029718
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License Number State | VA
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