Individual
RICHARD PROKOPCHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2850 KEAGY RD, SALEM, VA 24153-7458
(540) 375-9375
(540) 375-9376
Mailing address
2850 KEAGY RD, SALEM, VA 24153-7458
(540) 375-9375
(540) 375-9376
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
0101047984
VA
207RI0011X
Interventional Cardiology Physician
Primary
0101047984
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006096891
—
VA
01
—
P00290780
MEDICARE RAILROAD
VA
Enumeration date
01/30/2006
Last updated
08/15/2019
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