MEDICARE: NICOLE MARIAN RAGLAND 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	390200000X	Student in an Organized Health Care Education/Training Program
2	208M00000X	Hospitalist Physician	0101246019	VA

General Provider Information

NPI Number	:	1548478530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MARIAN RAGLAND MD

Provider Business Mailing Address
First Line	:	1201 BROAD ROCK BLVD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23249-0001
Country	:	US
Telephone Number	:	804-675-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 BROAD ROCK BLVD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23249-5051
Country	:	US
Telephone Number	:	804-675-5000
Fax Number	:

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

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	02/24/2025

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