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1538167796

NPI Code Detail

MEDICARE: RICHARD NORMAN WILLARD MD

MEDICARE: RICHARD NORMAN WILLARD 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	207VG0400X	Gynecology Physician	0101018092	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1538167796	OTHER	VA	COVENTRY HEALTH NETWORK
2	PAR	OTHER	VA	USA MANAGED CARE
3	PAR	OTHER	VA	CIGNA
4	-010	OTHER	VA	TRICARE/CHAMPUS
5	1538167796	OTHER	VA	UNITED HEALTHCARE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	492352	OTHER	VA	ANTHEM BC/BS
8	PAR	OTHER	VA	VIRGINIA HEALTH NETWORK
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	PAR	OTHER	VA	AETNA
11	PAR	OTHER	VA	CORVEL
12	10108888	OTHER	VA	OPTIMA HEALTH
13	1538167796	OTHER	VA	VIRGINIA PREMIER HEALTH PLAN

General Provider Information

NPI Number	:	1538167796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD NORMAN WILLARD MD

Provider Business Mailing Address
First Line	:	PO BOX 936
Second Line	:	EVMS MEDICAL GROUP
City	:	NORFOLK
State	:	VA
Zip	:	23501-0936
Country	:	US
Telephone Number	:	757-446-7900
Fax Number	:	757-446-7900

Provider Business Practice Location Address
First Line	:	825 FAIRFAX AVE
Second Line	:	SUITE 310
City	:	NORFOLK
State	:	VA
Zip	:	23507-1914
Country	:	US
Telephone Number	:	757-446-7900
Fax Number	:	757-446-8907

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	10/22/2013

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Directions to “ RICHARD NORMAN WILLARD MD” Practice Location

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