Organization
YORCKAY C ISHIZAWAR MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YORCKAY C ISHIZAWAR M.D. (PRESIDENT)
(804) 536-0107
Entity
Organization
Contact information
Practice address
211 TEMPLE AVE, COLONIAL HEIGHTS, VA 23834-2827
(804) 526-0107
(804) 526-4466
Mailing address
211 TEMPLE AVE, COLONIAL HEIGHTS, VA 23834-2827
(804) 526-0107
(804) 526-4466
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
02303295
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003865924
INDIVIDUAL NPI
VA
05
—
7382111
—
VA
Enumeration date
06/30/2008
Last updated
06/30/2008
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