MEDICARE: MR. JAMES RICHARD PASCHAL MD

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	207Q00000X	Family Medicine Physician	0101035974	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	010014877	OTHER	VA	MC RR
2	028920	OTHER	VA	ANTHEM

General Provider Information

NPI Number	:	1306820048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES RICHARD PASCHAL MD

Provider Business Mailing Address
First Line	:	330 E BAYVIEW BLVD
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23503-5205
Country	:	US
Telephone Number	:	757-583-1200
Fax Number	:	757-583-1682

Provider Business Practice Location Address
First Line	:	330 E BAYVIEW BLVD
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23503-5205
Country	:	US
Telephone Number	:	757-583-1200
Fax Number	:	757-583-1682

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

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	01/04/2010

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