Individual
RAPHAEL AGADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 S ADAMS ST, PETERSBURG, VA 23803-5149
(804) 862-5991
Mailing address
801 S ADAMS ST, PETERSBURG, VA 23803-5149
(804) 862-5991
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101840585
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205835725
BCBS
VA
05
—
1205835725
—
VA
Enumeration date
07/18/2005
Last updated
02/09/2009
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