Individual
DR. RICHARD M. WHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
825 FAIRFAX AVE, SUITE 118, NORFOLK, VA 23507-1914
(757) 446-5955
(757) 446-5196
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-5955
(757) 446-5196
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101039984
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-002
TRICARE/CHAMPUS
VA
05
—
1003881483
—
VA
01
—
426444
ANTHEM BC/BS
VA
01
—
426447
ANTHEM BC/BS
VA
05
—
5917806
—
NC
01
—
78535
OPTIMA HEALTH
VA
01
—
PAR
AETNA
VA
Enumeration date
02/21/2006
Last updated
10/03/2011
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