MEDICARE: RICHARD OHAGAN D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	0102034647	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174522551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD OHAGAN D.O.

Provider Business Mailing Address
First Line	:	11830 FISHING POINT DR
Second Line	:	STE 221
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-2586
Country	:	US
Telephone Number	:	757-232-8777
Fax Number	:	757-232-8866

Provider Business Practice Location Address
First Line	:	813 DILIGENCE DR
Second Line	:	STE 108
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-4237
Country	:	US
Telephone Number	:	757-873-0848
Fax Number	:	757-873-1559

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	07/08/2007

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