Individual
LAURA A RICCIARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3025 BERKMAR DR, SUITE 1, CHARLOTTESVILLE, VA 22901-1456
(434) 973-1831
(434) 973-1919
Mailing address
3025 BERKMAR DR, SUITE 1, CHARLOTTESVILLE, VA 22901-1456
(434) 973-1831
(434) 973-1919
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101228406
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010261864
—
VA
01
—
181906
ANTHEM BCBS
VA
01
—
317302
SOUTHERN HEALTH
VA
Enumeration date
06/01/2005
Last updated
11/07/2011
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