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Individual

RICHARD S. PERGOLIZZI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2602 BUFORD RD, NORTH CHESTERFIELD, VA 23235
(804) 272-8806
(804) 272-2909
Mailing address
2602 BUFORD RD, NORTH CHESTERFIELD, VA 23235-3422
(804) 272-8806
(804) 272-2909

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
0101231383
VA
2085N0700X
Neuroradiology Physician
0101231383
VA
2085N0904X
Nuclear Radiology Physician
0101231383
VA
2085P0229X
Pediatric Radiology Physician
0101231383
VA
2085R0202X
Diagnostic Radiology Physician
0101231383
VA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
0101231383
VA
2085U0001X
Diagnostic Ultrasound Physician
0101231383
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0060
CAREFIRST
VA
05
1053345256
VA
01
2680623
AETNA
VA
Enumeration date
07/11/2006
Last updated
08/30/2019
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