Individual
DR. BEVERLY DIANE GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7700 E PARHAM RD, RICHMOND, VA 23294-4301
(804) 747-5675
Mailing address
PO BOX 36559, RICHMOND, VA 23235-8011
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101033810
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
292276
ANTHEM-PARHAM RD
VA
01
—
66557
OPTIMAHEALTH
—
Enumeration date
07/28/2005
Last updated
08/10/2007
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