Individual
DR. MELVIN L PEGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5801 BREMO RD, RICHMOND, VA 23226-1907
(804) 287-7270
(804) 285-0726
Mailing address
6431 BAREBACK TER, NORTH CHESTERFIELD, VA 23234-4196
(804) 319-7831
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101223741
VA
208M00000X
Hospitalist Physician
0101223741
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083773089
NPI
VA
05
—
1083773089
—
VA
01
—
C06778
GROUP PTAN
VA
01
—
P00685255
RR MEDICARE
VA
Enumeration date
12/06/2006
Last updated
07/11/2022
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