Individual
MR. LOUIS RANDOLPH CHISHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13332 MIDLOTHIAN TPKE, MIDLOTHIAN, VA 23113-4210
(804) 794-5598
(804) 378-1954
Mailing address
13332 MIDLOTHIAN TPKE, MIDLOTHIAN, VA 23113-4210
(804) 794-5598
(804) 378-1954
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101029950
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100407
UNITED HEALTHCARE
VA
01
—
10527
CIGNA
VA
01
—
116043
ANTHEM
VA
01
—
36682
OPTIMA
VA
01
—
539779
AETNA
VA
01
—
540883363
VIRGINIA HEALTH NETWORK
VA
05
—
5633893
—
VA
01
—
82529
SOUTHERN HEALTH
VA
01
—
856745
MAMSI
VA
Enumeration date
05/11/2006
Last updated
07/19/2013
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