Individual
DR. DANIEL RANDOLPH RICCIARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
459 LOCUST AVE, MB 26, CHARLOTTESVILLE, VA 22902-4808
(434) 982-7150
(434) 982-7147
Mailing address
PO BOX 11647, DAYTONA BEACH, FL 32120-1647
(386) 274-7800
(386) 274-7801
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101227222
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
169384
ANTHEM SVC/HEALTHKEEPERS
VA
01
—
224870
SOUTHERN HEALTH
VA
01
—
31585
COMMUNITY HEALTH
VA
05
—
31585
—
VA
01
—
P00193734
MEDICARE PIN
VA
Enumeration date
01/24/2006
Last updated
08/06/2008
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