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Individual

DR. PETER BRUCE RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 COMMERCE RD, STAUNTON, VA 24401
(540) 213-0060
(540) 213-9441
Mailing address
17 N MEDICAL PARK DR, FISHERSVILLE, VA 22939-2344
(540) 213-7725
(540) 213-7481

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101032138
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006301754
VA
01
059755
BLUE CROSS BLUE SHIELD
VA
01
180020459
RAILROAD MEDICARE
Enumeration date
06/16/2005
Last updated
05/13/2010
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