Individual
RICHARD DAVID BAGNALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 KINGS WAY, SUITE 1400, WILLIAMSBURG, VA 23185-2505
(757) 345-2555
(757) 345-0366
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101102591
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003803149
—
VA
Enumeration date
10/04/2005
Last updated
09/30/2013
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