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Individual

RAUL RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2300 OPITZ BLVD, WOODBRIDGE, VA 22191-3311
(703) 670-1313
(800) 536-8431
Mailing address
PO BOX 75567, BALTIMORE, MD 21275-5567
(888) 898-3291
(800) 536-8431

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101031389
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001
BCBS
VA
05
5834813
VA
01
930109438
RAILROAD MEDICARE
VA
Enumeration date
05/16/2006
Last updated
06/03/2008
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